Clinical trial NCT05474989: LSD Treatment for Persons With Alcohol Use Disorder
Official title: LSD Treatment for Persons With Alcohol Use Disorder: A Multicenter, Double-blind, Randomized, Active-placebo Controlled Phase II Study
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: PHASE2
Conditions: Alcohol Use Disorder (AUD)
Lead sponsor: University Hospital, Basel, Switzerland
Sponsor class: OTHER
Collaborators: name: University of Bern
First posted: 2022-07-26
Enrollment: 126
Sex: ALL
Minimum age (years): 25
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Alcohol use causes more overall harm than any other drug and is the seventh leading risk factor for both deaths and disability-adjusted life years. Alcohol use disorders (AUD) are among the most common and undertreated mental disorders in developed countries. Pharmacological and psychotherapeutic treatments only show limited efficacy and around 60% of the patients relapse in the short-term after withdrawal.

Lysergic acid diethylamide (LSD) was investigated in numerous clinical trials during the 1950s and 1960s. Specifically, the use of LSD in the treatment of AUD was investigated extensively. A pooled analysis of six historical clinical trials demonstrated, that a single dose of LSD significantly reduced alcohol use at three and six months after LSD administration. However, these trials are limited by several factors, including the use of diagnostic standards that are no longer not up to date, single, high-dose treatment regimes, missing biological assessment for alcohol use, and no consequent assessment of blinding.

Therefore, the present study aims to evaluate the safety and efficacy of LSD for the treatment of AUD and addresses the shortcomings of previous studies. The trial has a double-blind, active placebo-controlled, randomized, parallel design and will be conducted in specialized treatment centers for addictive disorders in Switzerland. The study will include 126 patients after withdrawal treatment and will primarily assess the efficacy of LSD for the treatment of AUD. Patients will be treated using a 1:1 allocation. Each arm will last 20 weeks and will comprise nine study visits without drug administration and two study days involving LSD or active placebo administration. In the first session, patients in the treatment group will receive a dose of 150 µg LSD, followed by another 150 µg or 250 µg LSD in the second session, which will take place approximately 4 weeks after the first session.

The primary outcome is the mean of percent heavy drinking days after administration of two doses of LSD at 3 months follow-up. Additionally, the study will assess neurobiological mechanisms of action and several other measures.


Eligibility criteria: Key inclusion criteria:

* age ≥ 25 years
* moderate to severe AUD
* completion of a qualified detoxification for AUD within 30 days prior to screening
* a minimum of 4 heavy drinking days within the last 30 days before detoxification
* intention to stop or decrease drinking

Key exclusion criteria:

* significant alcohol withdrawal symptoms at screening
* participating or starting in any formal treatment for AUD until completion of visit 9
* cognitive impairment
* borderline personality disorder
* current post-traumatic stress disorder
* current suicidality or history of a serious suicide attempt
* significant prodromal symptoms
* history of a diagnosis of a psychotic or bipolar disorder in subjects or first-degree relatives
* pregnancy or breast-feeding
* lack of safe contraception are exclusion criterion for women only

Primary outcomes:
measure: Percent heavy drinking days
timeFrame: Period of three months after the second intervention
Secondary outcomes:
measure: Cortical thickness measured with MRI
timeFrame: Two weeks before first administration, two and 12 weeks after second administration
measure: The volume of the striatum measured with MRI
timeFrame: Two weeks before first administration, two and 12 weeks after second administration
measure: White matter microstructure measured with MRI
timeFrame: Two weeks before first administration, two and 12 weeks after second administration
measure: Days to first heavy drinking day
timeFrame: Three months after the second intervention
measure: Days to first drinking day
timeFrame: Three months after the second intervention
measure: Percent days abstinent
timeFrame: Three months after the second intervention
measure: Drinks per drinking day
timeFrame: Three months after the second intervention
measure: Adverse consequences of alcohol use
timeFrame: Three months after the second intervention
measure: Craving
timeFrame: Three months after the second intervention
measure: Ethyl glucuronide
timeFrame: Screening and three months after the second intervention
measure: Phosphatidylethanol
timeFrame: Screening, day of first intervention, day of second intervention, three months after the second intervention
measure: General health
timeFrame: Three months after the second intervention
measure: Depression
timeFrame: Three months after the second intervention
measure: Anxiety
timeFrame: Three months after the second intervention
measure: Blinding
timeFrame: In the evening after administration 1 (week 4) and administration 2 (week 8), respectively
measure: Safety: Adverse events
timeFrame: Week 0 to week 20
Other outcomes:
Locations:
city: Basel
country: Switzerland
facility: University Hospital of Psychiatry, University of Basel
city: Bern
country: Switzerland
facility: University Hospital of Psychiatry, University of Bern
Study officials:
References: