The Effect of Glutamatergic Modulation on Cocaine Self-administration

Study Overview
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Brief Summary
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Repeated drug consumption may progress to problematic use by triggering neuroplastic adaptations that attenuate sensitivity to natural rewards while increasing reactivity to craving and drug cues. Converging evidence suggests that glutamate modulation may work to correct these adaptations and rapidly restore motivation for delayed non-drug rewards relative to immediate drug use. Using an established laboratory model aimed at evaluating behavioral shifts in the salience of cocaine now vs. money later, the investigators will test the effect of CI-581a on cocaine self-administration as compared to the active control.

Conditions
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Cocaine Dependence

Intervention / Treatment
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* Drug: CI-581a
* Drug: CI-581b


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Active cocaine dependence with at least 8 days of use or at least 4 binges of large amounts (>$200/occasion) over the past 30 days, and displaying at least one positive utox during screening Physically healthy No adverse reactions to study medications 21-55 years of age Capacity to consent and comply with study procedures, including sufficient proficiency in English Not seeking treatment Exclusion Criteria: Meets DSM IV criteria for current major depression, bipolar disorder, schizophrenia, any psychotic illness, including substance induced psychosis, and current substance-induced mood disorder with HAMD score > 12. Physiological dependence on another substance, such as alcohol, opioids, or benzodiazepines, excluding caffeine, nicotine, and cannabis Delirium, Dementia, Amnesia, Cognitive Disorders, or Dissociative disorders Current suicide risk or a history of suicide attempt within the past year Pregnant or interested in becoming pregnant during the study period Any of the following cardiac conditions: clinically significant left ventricular hypertrophy, angina, clinically significant arrhythmia, or mitral valve prolapse Unstable physical disorders which might make participation hazardous such as end-stage AIDS, hypertension (>140/90), WBC < 3.5, active hepatitis or other liver disease with elevated transaminase levels (< 2-3 X upper limit of normal will be considered acceptable if PT/PTT is normal), renal failure (creat > 2, BUN >40), or untreated diabetes Previous history of ketamine or midazolam misuse or abuse, and a history of an adverse reaction/experience with prior exposure to cocaine, ketamine or midazolam Recent history of significant violence (past 2 years) Abnormal pseudocholinesterase level First degree relative with a psychotic disorder (bipolar disorder, schizophrenia, schizoaffective disorder, or psychosis NOS) BMI > 35, or a history of documented obstructive sleep apnea On psychotropic or other medications whose effect could be disrupted by participation in the study

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 55 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: CI-581a<br>Administration of CI-581a followed 2 weeks later by CI-581b | Drug: CI-581a<br>* a 50 minute infusion 24 hours prior to cocaine self-administration session<br>Drug: CI-581b<br>* a 50 minute infusion 24 hours prior to cocaine self-administration session<br>|
| Active Comparator: CI-581b<br>Administration of CI-581b followed 2 weeks later by CI-581a | Drug: CI-581a<br>* a 50 minute infusion 24 hours prior to cocaine self-administration session<br>Drug: CI-581b<br>* a 50 minute infusion 24 hours prior to cocaine self-administration session<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Choices to Self-administer Cocaine (Out of 5 Choices) | Participants provided 5 choices (cocaine 25 mg now vs. $11 later), with choices spaces 15 minutes apart over the course of the session. | 24 hours post-infusion |