Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation (ConNicBrain)
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Purpose
The purpose of this study is to look at brain function in order to understand how different treatments to help people quit smoking work. In this study, the investigators will look at the effects of nicotine patches, Chantix alone or Chantix paired with Zyban.
| Condition | Intervention | Phase |
|---|---|---|
|
Nicotine Dependence |
Drug: Varenicline Drug: Bupropion Drug: Nicotine patches |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver) Primary Purpose: Treatment |
| Official Title: | Mechanistic Evaluations of Pre-Cessation Therapies for Smoking Cessation |
- The amygdala and ventral anterior cingulate gyrus (vACG) scans will be compared to evaluate significant differences [ Time Frame: change from baseline in whole brain blood-oxygen-level dependent (BOLD) contrast sensitive fMRI images collected during a cue-reactivity task following 2 weeks of pre-quit treatment ] [ Designated as safety issue: No ]
- Days to First Cigarette Following Quitting Smoking [ Time Frame: 11 weeks post quit day and 6 months post quit day. ] [ Designated as safety issue: No ]Days to first cigarette (i.e. lapse) will be measured via self-report. Correlations between pre- and post-quit brain imaging measures and days to lapse will be examined to assess whether brain function can predict cessation outcomes.
| Estimated Enrollment: | 1000 |
| Study Start Date: | July 2011 |
| Estimated Primary Completion Date: | May 2015 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: varenicline (Chantix) |
Drug: Varenicline
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12 weeks.
Other Name: Chantix
Drug: Nicotine patches
Placebo Group: 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Nicotine Replacement Therapy (NRT) Group:21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Varenicline and varenicline in combination with bupropion groups: 21 mg/24 h for 1 week before the quit date Other Name: Nicoderm
|
| Active Comparator: NRT (nicotine patches only) |
Drug: Nicotine patches
Placebo Group: 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Nicotine Replacement Therapy (NRT) Group:21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Varenicline and varenicline in combination with bupropion groups: 21 mg/24 h for 1 week before the quit date Other Name: Nicoderm
|
| Active Comparator: varenicline (Chantix) w/ bupropion (Zyban) |
Drug: Varenicline
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive varenicline at a dose of 0.5 mg once per day followed by 0.5 mg twice a day for the remaining 4 days of that week. Subsequently, the dose will be 1 mg twice per day, and will remain at that dose for the remainder of the 12 weeks.
Other Name: Chantix
Drug: Bupropion
For the first 3 days after being switched from Nicotine Replacement Therapy (NRT) occurring at one week before the target quit date, smokers in this group will receive bupropion at a dose of 150mg once per day. Subsequently, the dose will be 150mg twice per day, and will remain at that dose for the remainder of the 12 weeks.
Other Name: Zyban
Drug: Nicotine patches
Placebo Group: 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Nicotine Replacement Therapy (NRT) Group:21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Varenicline and varenicline in combination with bupropion groups: 21 mg/24 h for 1 week before the quit date Other Name: Nicoderm
|
| Placebo Comparator: Placebo oral drugs w/ nicotine patches |
Drug: Nicotine patches
Placebo Group: 21 mg/24 h for 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Nicotine Replacement Therapy (NRT) Group:21 mg/24 h for 2 weeks before the quit date and 7 weeks after the quit date, 14 mg/24 h for 2 weeks, and 7 mg/ 24 h for 2 weeks. Varenicline and varenicline in combination with bupropion groups: 21 mg/24 h for 1 week before the quit date Other Name: Nicoderm
|
Eligibility| Ages Eligible for Study: | 18 Years to 50 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Are generally healthy;
- Are 18-50 years old;
- Smoke an average of at least 10 cigarettes per day for at least three cumulative years;
- Have an afternoon expired air carbon monoxide (CO) reading of at least 10ppm;
- Are right-handed as measured by a two-item scale used in our laboratory;
- Express a desire to quit smoking in the next thirty days.
- Potential subjects must agree to use acceptable contraception during their participation in this study.
Potential subjects must agree to avoid the following during their participation in this study:
- participation in any other nicotine-related modification strategy outside of this protocol;
- use of tobacco products other than cigarettes, including pipe tobacco, cigars, e-cigarettes, snuff, and chewing tobacco;
- use of experimental (investigational) drugs or devices;
- use of illegal drugs;
- use of opiate medications.
Exclusion Criteria:
- Inability to attend all required experimental sessions;
- Presence of conditions that would make MRI unsafe (e.g. pacemaker);
- Hypertension (systolic >140 mm Hg, diastolic >100 mm Hg, coupled with a history of hypertension); subjects with no previous diagnosis of hypertension may have a screening blood pressure up to 160/100.
- Hypotension with symptoms (systolic <90 mm Hg, diastolic <60 mm Hg).
- Coronary heart disease;
- Lifetime history of heart attack;
- Cardiac rhythm disorder (irregular heart rhythm);
- Chest pains (unless history, exam, and ECG clearly indicate a non-cardiac source);
- Cardiac (heart) disorder (including but not limited to valvular heart disease, heart murmur, heart failure);
- History of skin allergy;
- Active skin disorder (e.g., psoriasis) within the last five years, except minor skin conditions (including but not limited to facial acne, minor localized infections, and superficial minor wounds);
- Liver or kidney disorder (except kidney stones, gallstones);
- Gastrointestinal problems or disease other than gastroesophageal reflux or heartburn;
- Active ulcers in the past 30 days;
- Lung disorder (including but not limited to Chronic obstructive pulmonary disease (COPD), emphysema, and asthma);
- Brain abnormality (including but not limited to stroke, brain tumor, and seizure disorder);
- Migraine headaches that occur more frequently than once per week;
- Recent, unexplained fainting spells;
- Problems giving blood samples;
- Diabetes;
- Current cancer or treatment for cancer in the past six months (except basal or squamous cell skin cancer);
- Other major medical condition;
- Current psychiatric disease (with the exception of anxiety disorders, Obsessive-compulsive disorder (OCD) and Attention deficit hyperactivity disorder (ADHD));
- Bulimia or anorexia;
- Suicidal ideation (within the past 10 years) or lifetime occurrence of attempted suicide;
- Current depression;
- Pregnant or nursing mothers;
- Alcohol abuse;
- Significant adverse reaction to nicotine patch, bupropion/Wellbutrin/Zyban or Chantix/Varenicline in the past.
Use (within the past 30 days) of:
- Illegal drugs (or if the urine drug screen is positive);
- Experimental (investigational) drugs;
- Psychiatric medications including antidepressants, anti-psychotics or any other medications that are known to affect smoking cessation (e.g. clonidine);
- Smokeless tobacco (chewing tobacco, snuff), cigars or pipes;
- Nicotine replacement therapy or any other smoking cessation aid.
Use (within the past 14 days) of:
- Opiate medications for pain or sleep (non-opiate medication for pain or sleep will be allowed).
Contacts and Locations| Contact: David Botts | 919-668-5055 | david.botts@duke.edu |
| Contact: Tanaia Loeback | 919-668-5055 | loeba001@mc.duke.edu |
| United States, North Carolina | |
| Duke Center for Nicotine and Smoking Cessation Research | Recruiting |
| Durham, North Carolina, United States, 27705 | |
| Duke Center for Nicotine and Smoking Cessation Research | Recruiting |
| Raleigh, North Carolina, United States, 27609 | |
| Principal Investigator: | F. Joseph McClernon, Ph.D. | Duke University |
More Information
No publications provided
| Responsible Party: | Duke University |
| ClinicalTrials.gov Identifier: | NCT01406223 History of Changes |
| Other Study ID Numbers: | Pro00028331, 1P50DA027840-01A1 |
| Study First Received: | June 12, 2011 |
| Last Updated: | May 1, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Duke University:
|
Nicotine addiction Cigarette smoking Smoking cessation Zyban Chantix |
Nicotine patches varenicline bupropion fMRI |
Additional relevant MeSH terms:
|
Tobacco Use Disorder Smoking Substance-Related Disorders Mental Disorders Habits Nicotine Nicotine polacrilex Varenicline Bupropion Ganglionic Stimulants Autonomic Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions |
Nicotinic Agonists Cholinergic Agonists Cholinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Central Nervous System Stimulants Central Nervous System Agents Therapeutic Uses Antidepressive Agents, Second-Generation Antidepressive Agents Psychotropic Drugs Dopamine Uptake Inhibitors Dopamine Agents Neurotransmitter Uptake Inhibitors |
ClinicalTrials.gov processed this record on May 19, 2013