Safety and Tolerability of Modafinil for Methamphetamine Dependence

Study Overview
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Brief Summary
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This 7 week, open-label pilot clinical trial will examine the safety and tolerability of modafinil up to 400mg/day as a potential treatment to reduce methamphetamine use in methamphetamine-dependent volunteers.

Official Title
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Safety and Tolerability of Modafinil for Methamphetamine Dependence

Conditions
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Methamphetamine Dependence

Intervention / Treatment
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* Drug: Modafinil


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18-65 years old not currently enrolled in a treatment program subjects must have a history of methamphetamine use with recent use confirmed by a positive urine toxicology screen for amphetamines during the month prior to study entry subjects must meet DSM-IV criteria for amphetamine dependence as assessed by the substance abuse section of the Structured Clinical Interview for DSM-IV (SCID) women of childbearing age must have a negative pregnancy test to enroll in this study, agree to monthly pregnancy testing, and agree to use appropriate forms of birth control for the duration of the study Exclusion Criteria: current diagnosis of alcohol, opiate, or sedative physical dependence ill health (e.g., major cardiovascular, renal, endocrine, hepatic disorder) history of schizophrenia, or bipolar type I disorder present or recent use of over-the-counter or prescription psychoactive drug or drug(s) that would be expected to have major interaction with drug to be tested medical contraindication to receiving study medications (e.g., allergy to modafinil, treatment with cyclosporine, clomipramine, or desipramine) Current suicidality or psychosis liver function tests (i.e., liver enzymes) greater than three times normal levels pregnancy or breastfeeding

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Intervention/Treatment |
| --- |
|Drug: Modafinil|subjects attend clinic for the first week in order to receive meds; oral, 200mg/day doses for three days for initiation doses; increased to oral 400mg/day for the remainder of the trial (weeks 2-6); washout period during week 7|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart Rate | Heart rate as a safety measure was measured by thrice weekly measuring heart rate in beats per minute. | Thrice weekly for 7 weeks | 
| Systolic Blood Pressure | Systolic blood pressure as a safety measure was measured by thrice weekly measuring blood pressure in mmHg. | Thrice weekly for 7 weeks | 
| Diastolic Blood Pressure | Diastolic blood pressure as a safety measure was measured by thrice weekly measuring blood pressure in mmHg. | Thrice weekly for 7 weeks | 
| Modafinil Side Effects Checklist | Modafinil side effects were measured weekly by means of the Modafinil Side Effects Checklist which asked participants to rate their experience of the following potential side effects: headaches, nausea, nervousness, runny nose, diarrhea, back pain, anxiety, insomnia, dizziness and upset stomach. Participants rated their experience on a 4 point scale ranging from not at all (0) to very much (4). The score was determined by units on a scale. | Weekly for 7 weeks | 
| Anxiety as Measured by the Hamilton Anxiety Scale | Participants were administered the Hamilton Anxiety Scale thrice weekly throughout the study. The scale is a 14 item questionaire with scores ranging from 0 to 56. | Thrice weekly for 7 weeks | 
| Depression as Measured by the Hamilton Depression Scale | Participants were administered the Hamilton Depression Scale thrice weekly throughout the study. The scale is a 21 item questionaire with scores ranging from 0 to 62 with a cutoff for depression of 15. | Thrice weekly for 7 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Methamphetamine Withdrawal as Measured Using the Amphetamine Withdrawal Questionaire. | The Amphetamine Withdrawal Questionaire was given at intake and 3 times weekly during the first 3 weeks of the study. This time span was chosen due to the tendency of methamphetamine withdrawal to enter an acute phase in the first week after last use with a subsequent subacute phase following for the next two weeks(McGregor et al, 2005). This questionaire is comprised of 10 items which describe symptoms associated with the cessation of chronic amphetamine use for which participants indicate severity on a 4-point scale. The minimum score is 0 and the maximum score is 40. | Thrice weekly for the first three weeks |