Clinical Efficacy of Sertraline Augmented With Gabapentin in Depressed, Recently Abstinent Cocaine-dependent Humans
Condition: Cocaine Dependence; Depressive Symptoms
MeSH terms: Cocaine-Related Disorders; Depression
Study type: Interventional
Phase: Phase 2

Summary: 
      To examine the clinical efficacy of sertraline (200 mg/day) alone or sertraline in
      combination with gabapentin. The purpose of this study is to examine whether the
      antidepressant sertraline alone or combined with gabapentin delays time to relapse relative
      to placebo in recently abstinent cocaine-dependent volunteers who are also depressed. In
      addition, whether depressive symptoms or genetic factors influence treatment response to the
      study medications will be examined. Our hypothesis is that those on combined
      sertraline-gabapentin will show a longer period of abstinence than those on sertraline alone
      or placebo.
    

Detailed description: 
      Subjects enrolled in this 12-wk, double blind, randomized, placebo-controlled, clinical trial
      are admitted to a residential facility in North Little Rock (RCA-NLR) and randomized by
      depressive symptom severity to receive one of the following: sertraline alone (200 mg/day),
      sertraline (200 mg/day) plus gabapentin (1200 mg/day), or placebo. Subjects are expected to
      participate in the Substance Abuse Day Treatment Program while residing on the RCA-NLR and
      being inducted onto the maintenance dose of study medication (weeks 1-2). When participants
      transfer to the Outpatient Treatment Research Unit (TRU) at the start of their third week,
      they will continue to receive study medications or placebo (weeks 3-12) and they will be
      expected to participate in weekly individual cognitive behavioral therapy. Supervised urines
      and vital signs will be obtained thrice weekly; self-reported adverse effects, mood and drug
      use self-reports will be obtained once weekly. At the end of 12 weeks, participants will be
      tapered off the study medication over a five-day period, discharged from the study, and
      referred to an appropriate treatment or treatment/research program in the community if they
      are interested.
    

Intervention name(s): sertraline; Placebo; gabapentin
Intervention type(s): Drug; Drug; Drug
Intervention description(s): Sertraline hydrochloride (200 mg/day) will be administered once daily. While subjects are at RCA-NLR they initially receive 50 mg/day of sertraline. This dose is gradually increased over a 3-week period until subjects receive 200 mg. When subjects are transferred to the outpatient program, they will be administered capsules once weekly, with take-home doses given in blister packs to take once a day for the rest of the week.; Placebo (cellulose or lactose) administered twice per day for 12 weeks.; Gabapentin (Neurontin; Parke-Davis; 1200 mg/day) will be administered twice daily. Initially, patients will receive 200 mg twice daily on days 1-5, 400 mg twice daily on days 6-10, then 600 mg twice daily on days 11 on. Subjects are then maintained on this dose for the duration of the trial, unless side-effects are too severe, in which case the dose of gabapentin is decreased to no less 800 mg/day. If symptoms persist, subjects' participation would then be terminated.
Intervention MeSH terms: Gabapentin; Sertraline
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cocaine dependence; depressive symptoms; relapse; sertraline; gabapentin