Minocycline and Tobacco Craving in Smokers With Schizophrenia
Condition: Schizophrenia; Tobacco Use
MeSH terms: Schizophrenia
Study type: Interventional
Phase: Phase 4

Summary: 
      Craving for cigarettes is an important aspect that leads to challenges with smoking
      cessation. Persons with schizophrenia are more likely to smoke and to be heavier smokers than
      persons without schizophrenia, and may experience craving differently as well. Minocycline is
      an antibiotic medication that may impact craving. We will conduct a two-week randomized,
      double-blind, placebo-controlled, parallel group pilot study to investigate the effects of
      minocycline vs. placebo on craving and smoking behaviors in smokers with schizophrenia.
      Participants will take minocycline or matching placebo for two weeks. Participants will be
      assessed on aspects of craving and smoking behavior at baseline and after 1 and 2 weeks of
      minocycline or placebo treatment.
    

Detailed description: 
      Nicotine dependence is high in schizophrenia; nearly three times more prevalent than the
      general population. In smokers with schizophrenia, the risk of all-cause mortality is doubled
      and cardiovascular mortality risk is twelvefold higher than nonsmokers. Many factors
      influence smoking in persons with schizophrenia, but predictors of craving and smoking
      behavior are not well established. Craving is a major contributor to smoking behaviors, and,
      importantly, is a predictor of relapse risk. Since craving may precede relapse, it can be
      advantageous as a screening tool for those attempting cessation. In addition, focusing on
      treatments aimed to reduce craving may lead to better therapeutic targets. Minocycline may
      affect craving, perhaps due to inhibition of nitric oxide (NO) formation, as NO acts as a
      second messenger for glutamate and dopamine receptors. NO also facilitates the effects of
      nicotine in the reward circuit, and blockade of NO has been demonstrated to eliminate
      nicotine abstinence symptoms in rats. A small study has demonstrated that minocycline reduces
      cigarette craving in human subjects without severe mental illness. The investigators will
      conduct a two-week randomized, double-blind, placebo-controlled, parallel group pilot study
      to investigate the effects of minocycline vs. placebo on craving and indicators of smoking
      intensity in smokers with schizophrenia. Participants will take minocycline up to 200 mg
      daily or matching placebo for two weeks. Participants will complete cigarette cue-elicited
      craving platforms and related assessments at baseline, and after 1 and 2 weeks of minocycline
      or placebo treatment.
    

Intervention name(s): Minocycline; Placebo
Intervention type(s): Drug; Other
Intervention description(s): Minocycline capsules taken twice daily for two weeks.; Placebo capsules taken twice daily for two weeks.
Intervention MeSH terms: Minocycline
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Other