Quetiapine for the Reduction of Cocaine Use
Condition: Cocaine Dependence; Cocaine Abuse; Cocaine Addiction; Drug Abuse; Substance Abuse
MeSH terms: Substance-Related Disorders; Cocaine-Related Disorders; Behavior, Addictive
Study type: Interventional

Summary: 
      This placebo-controlled trial will test the effectiveness of Seroquel XR™ for the treatment
      of cocaine dependence in non-psychotic individuals who are cocaine dependent.
    

Detailed description: 
      Cocaine abuse continues to be an epidemic. Co-morbid psychiatric disorders and high risks
      behaviors compound the morbidity, economic costs, and social destruction associated with this
      public health crisis. This is a 12 week, prospective, intent-to-treat, double-blind,
      randomized, placebo-controlled study of Seroquel XR™ versus matched placebo, combined with
      cognitive-behavioral group therapy, for the treatment of cocaine dependence in non-psychotic
      individuals.

      We will conduct this study at the American Lake (Tacoma) and Seattle campuses of the VA Puget
      Sound Health Care System, recruiting veteran and non-veteran participants currently using
      cocaine from the greater Pierce and King Counties region. It is anticipated that 120 subjects
      will be consented and screened for study participation and that 60 subjects will be
      randomized to treatment.

      After subjects have provided informed consent, they will enter a 1 week screening phase
      during which medical, psychiatric, and substance use measures and assessments will be
      administered to determine study eligibility. At baseline, we will assess cocaine use, cocaine
      craving, psychiatric symptoms, and high risk behaviors. Also at this visit, subjects will be
      randomly assigned to treatment with quetiapine (target dose 400 mg/day) or placebo. During
      the treatment phase, subjects will visit the clinic once a week for safety monitoring,
      completion of ratings and questionnaires, UDS's, and participation in a cognitive-behavioral
      therapy group. At end of study, week 12, a physical examination will be administered and a
      UDS and clinical laboratory values obtained. In addition, substance use, psychiatric
      symptoms, and high risk behaviors will be assessed. To monitor safety and further evaluate
      treatment effects, we will ask participants to return for a follow-up visit at week 16.
    

Intervention name(s): quetiapine fumarate; Matched Placebo; Cognitive-behavioral Therapy
Intervention type(s): Drug; Drug; Behavioral
Intervention description(s): At baseline, subjects in the experimental group will initially be administered 50 mg/day of Seroquel XR™ (extended release formulation of quetiapine fumarate), to be titrated up to 400 mg/day of Seroquel XR™ by the end of the second week. By the end of week 2, subjects will be stabilized on a dose of 400 mg/day or alternatively 300, 200, 100, or 50 mg/day of study drug, as tolerated. If a subject is unable to tolerate the 50 mg/day dose, he or she will be discontinued from the drug portion of the study.; Subjects randomized to the placebo comparator group will follow the same titration and dosing procedures as the experimental group, but will receive matched placebo tablets.; During the 12 week treatment phase, all subjects attended weekly group cognitive-behavioral therapy sessions. This therapy platform utilized the cognitive-behavioral therapy manual, Seeking Safety. Seeking Safety has been shown to effectively reduce substance use and to improve psychological functioning in a variety of populations.
Other intervention name(s): Seroquel XR
Intervention MeSH terms: Quetiapine Fumarate
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cocaine; quetiapine fumarate; dependence; abuse; addiction; treatment