Interdisciplinary Study of Two Novel Anticonvulsants in Alcoholism



Status:Completed
Conditions:Psychiatric
Therapuetic Areas:Psychiatry / Psychology
Healthy:No
Age Range:21 - 65
Updated:11/23/2013
Start Date:May 2009
End Date:March 2015
Contact:Caitlin Surprise, BA
Email:caitlin.surprise@bmc.org
Phone:617-414-1990

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A Double-Blind, Placebo-Controlled, Parallel Group Design Trial of; Levetiracetam, Zonisamide, Topiramate, and Placebo Control for the Treatment of Alcohol Dependent Subjects.


This is a double-blind, placebo-controlled, parallel group design study with 4 treatment
groups; levetiracetam, zonisamide, topiramate, and placebo control. Subjects will receive
study medications for 14 weeks. Potential subjects will be initially screened for interest
in study participation and alcohol consumption level to determine basic eligibility by
telephone, or in person. Individuals who meet telephone screening criteria will be scheduled
for a clinic appointment to obtain informed consent and conduct screening assessments.
Subjects who report average drinks per day that are within the guidelines for safe levels of
alcohol consumption (i.e. 2 drinks/ day males; 1 drink/day females-HHS standard) in the two
weeks prior to screening will be excluded. Subjects meeting screening criteria will be
scheduled for a second randomization visit. During this visit baseline assessments will be
obtained. Eligible subjects will then be randomized to a treatment group and will be
provided with the first week's study medications. The goal is to directly compare the
efficacy and tolerability of two novel anticonvulsants, zonisamide and levetiracetam, with
placebo, and using topiramate, which has extensive evidence supporting its efficacy in
alcoholism, as a positive control group. We believe that this will be the first direct
comparison of these agents in alcoholism, and the results will provide information on the
efficacy and safety of the medications.


Inclusion Criteria:

To be admitted into this study candidates must meet the following criteria:

1. DSM-IV-TR Diagnosis of Alcohol Dependence.

2. A minimal level of an average of 28 standard drinks per week for women or 35 drinks
per week for men over a baseline 28 day consecutive period prior to the screening
session during the 90 day time line follow-back.

3. Male or Female 21- 65 years of age.

4. Able to provide informed consent and comprehend study procedures.

5. Negative urine toxicological screen for opioids, cocaine, amphetamines,
methamphetamine, and benzodiazepines. The test may be repeated for opioids or
benzodiazepines shown to be medically prescribed for an acute disorder. The urine
test may also be repeated if the Investigator deems necessary.

6. A score of >8 on the Alcohol Use Disorder Identification Test (AUDIT) during
screening.

7. Must be suitable for outpatient management of alcoholism.

8. Express desire to stop drinking or reduce alcohol consumption.

9. Provide contact information for themselves or an alternate contact that the staff
will call in case of missed appointment.

10. Women must be postmenopausal for at least one year, be surgically sterile, or be
using an effective method of birth control.

11. Must be able to take oral medications, adhere to the regimen and be willing to return
for follow up visits.

Exclusion Criteria:

Subjects meeting the following criteria will be excluded from the study:

1. Dependent on DSM IV-TR drugs or substances other than ethanol, nicotine, or caffeine.

2. DSM IV-TR diagnosis of any current Axis I diagnosis other than alcohol dependence,
nicotine dependence, or caffeine dependence that in the opinion of the study
physicians might require intervention with either pharmacological or
non-pharmacological therapy that will interfere with the course of the study.

3. Receiving inpatient treatment for alcohol dependence, other then alcohol
detoxification, within 4 weeks prior to enrollment into this study.

4. Subjects with a score of 10 or greater on the Clinical Institute Withdrawal
Assessment for Alcohol-Revised on first or second visits.

5. Being treated with acamprosate, disulfiram or naltrexone within two weeks prior to
randomization:

6. Currently being treated with any of the following medications: a) antipsychotic
agents. b) antimanic or anticonvulsant agents. c) sedative- hypnotics. d) chronic
opioid treatment. e) psychomotor stimulants- amphetamine derivatives, methylphenidate

7. Subjects who are legally mandated to participate in an alcohol treatment program.

8. Use of any medication known to inhibit or induce cytochrome P450 3A4 enzymes.

9. Subjects who have attempted suicide or who have had suicidal ideation within 30 days
of their first visit.

10. Subjects with renal disease or history of kidney stones.

11. Subjects with AST or ALT >3 times the upper limit of the normal range during
screening.

12. History of significant neurological disorder.

13. Subjects who are pregnant (as assessed by serum HCG) or lactating.

14. Subjects known to have clinically significant medical conditions that in the opinion
of the study physician would preclude administration of the study medications or
limit participation in the clinical trial.

15. Subjects with history of treatment with levetiracetam, topiramate or zonisamide.

16. Score of 25 or less on the Folstein Mini- Mental examination.

17. History of anticonvulsant-induced rash.

18. Taking drugs that contain "sulfa" moeity, such as sulfonamides, sulfonylureas,
carbonic anhydrase inhibitors, thiazides, and loop diuretics (except ethacrynic
acid).

19. During the 2 weeks prior to screening subjects who report average drinks per day that
are within the guidelines for safe levels of alcohol consumption (i.e. 2 drinks/ day
males; 1 drink/day females-HHS standard) will be excluded.

20. Subjects with a sulfa allergy.

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