Clinical trial NCT03018236: Effect of N-acetylcysteine on Alcohol and Cocaine Use Disorders: A Double-Blind Randomized Controlled Trial.
Official title: The Effect of N-acetylcysteine (NAC) on Treatment of Alcohol and Cocaine Use Disorders: A Double-Blind Randomized Controlled Trial.
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE4
Conditions: Cocaine Addiction
Alcohol Addiction
Keywords: cocaine
alcohol
substance use disorders
addiction
N-acetylcysteine
randomized controlled trial
Lead sponsor: Hospital de Clinicas de Porto Alegre
Sponsor class: OTHER
Collaborators: name: Secretaria Nacional de Políticas sobre Drogas (SENAD)
First posted: 2017-01-11
Enrollment: 100
Sex: MALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study evaluates the use of N-acetylcysteine in the treatment of alcohol and cocaine use disorders. Alcohol users will be split in two groups, one will receive the active N-acetylcysteine and the other placebo. The same division will occur with cocaine users. The effects of N-acetylcysteine in adherence, abstinence, psychiatric symptoms and stress biomarkers will be evaluated.

Detailed description: N-acetylcysteine acts replenishing the human body glutathione storages. Glutathione is an important antioxidant agent, and also modulates the N-methyl-D-aspartate (NMDA) glutamatergic receptor. Glutamate has been associated with the neuroadaptation related to substance use disorders, and thus it is considered a potential target for pharmacological interventions regarding these disorders. N-acetylcysteine also interacts with the cystine-glutamate antiporter on astrocytes hence increasing glutamate release into the extracellular space.

N-acetylcysteine effects and its implications in the addiction disorders have been studied initially with animal models. Glutamate levels normalization through N-acetylcysteine reduced compulsive drug self-administration and drug-seeking behavior in mice. In addition, there are promising results also with human subjects, showing benefits for cocaine, alcohol and cannabis use disorders.

This study consists of a randomized, double-blind, placebo controlled trial with four arms: alcohol users divided into NAC vs Placebo and cocaine users divided into NAC vs Placebo.

Eligibility criteria: Inclusion Criteria:

* Diagnostic of Alcohol or Cocaine Use Disorder
* Seven days of inpatient treatment in an addiction treatment specialized unit

Exclusion Criteria:

* Another Substance Use Disorder (exception: tobacco)
* Severe medical conditions (cardiac, renal or hepatic), that preclude subject participation
* History of asthma or convulsions medication use
* Recent use (\<14 days) of any medication that could interfere with the study medication
* History of anaphylactic reactions with the study medication
* Suicide risk
* Inability to understand the informed consent form or to comply with the study requirements
* Any severe neuropsychiatric condition, not caused by the substance use, that requires specific medication treatments and could interfere with the study development, in the investigators opinion (for instance: dementia, schizophrenia or other psychoses, multiple sclerosis, severe depression, stroke, epilepsy, bipolar disorder)
* Failing to complete the screening procedures prior to the study first week

Primary outcomes:
measure: Number of participants who attended all study appointments
timeFrame: 8 weeks
Secondary outcomes:
measure: Abstinence by urine
timeFrame: 8 weeks
measure: Abstinence by breathalyzer
timeFrame: 8 weeks
measure: Abstinence by self report
timeFrame: 8 weeks
measure: Days of inpatient treatment
timeFrame: Up to 4 weeks
measure: Change in scores of CGI
timeFrame: 8 weeks
measure: Change in scores of FAST
timeFrame: 8 weeks
measure: Depressive symptoms
timeFrame: 8 weeks
measure: Anxiety symptoms
timeFrame: 8 weeks
measure: BDNF
timeFrame: 8 weeks
measure: GSSG
timeFrame: 8 weeks
measure: GSH
timeFrame: 8 weeks
measure: GPx
timeFrame: 8 weeks
measure: CAT
timeFrame: 8 weeks
measure: TBARS
timeFrame: 8 weeks
measure: SOD
timeFrame: 8 weeks
measure: Carbonyl
timeFrame: 8 weeks
Other outcomes:
measure: Adverse events
timeFrame: 8 weeks
Locations:
city: Porto Alegre
country: Brazil
facility: Hospital de Clinicas de Porto Alegre - Unidade Alvaro Alvim
state: RS
Study officials:
affiliation: Federal University of Rio Grande do Sul (UFRGS)
name: Lisia von Diemen, PhD
role: STUDY_CHAIR
affiliation: Federal University of Rio Grande do Sul (UFRGS)
name: Flavio Pechansky, PhD
role: PRINCIPAL_INVESTIGATOR
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