Aripiprazole for Bipolar Disorder and Alcohol Use Disorder
| Status: | Recruiting |
|---|---|
| Conditions: | Psychiatric, Psychiatric, Psychiatric, Bipolar Disorder |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 3/13/2019 |
| Start Date: | November 2016 |
| End Date: | November 2020 |
| Contact: | Giselle Chery |
| Email: | giselle.chery@utsouthwestern.edu |
| Phone: | 214-645-6957 |
The investigators will conduct a 12-week, randomized, double-blind, parallel-group,
placebo-controlled study of aripiprazole in 132 persons with Alcohol Use Disorder (AUD) and
bipolar I or II disorder, currently depressed or mixed phase. Primary Aim will be to assess
change in alcohol use by the Timeline Followback (TLFB) method. Secondary Aim will include
change in alcohol craving using the Penn Alcohol Craving Scale (PACS). Changes in psychiatric
symptoms (mania/hypomania and depression) and predictors of response will be assessed.
Participants with ≥ 1 drinking day at week 12 will be enrolled in a 4-week extension phase
with an upward titration to 30 mg/day for those in the active treatment group. The placebo
group will remain on placebo.
Subjects will be discontinued from the study if any of the following conditions occurs:
change in diagnosis to other than bipolar I or II disorder and AUD, development of active
suicidal or homicidal ideation with plan and intent, worsening in mood symptoms, that in the
opinion of the investigators requires discontinuation, pregnancy, development of severe or
life-threatening medical condition, involuntary psychiatric hospitalization or incarceration,
significant alcohol withdrawal (e.g. delirium tremens) based on clinical judgment (increases
in Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scores will initiate a
careful clinical assessment of possible worsening of withdrawal symptoms), or cocaine or
amphetamine-positive urine drug screen during the study.
placebo-controlled study of aripiprazole in 132 persons with Alcohol Use Disorder (AUD) and
bipolar I or II disorder, currently depressed or mixed phase. Primary Aim will be to assess
change in alcohol use by the Timeline Followback (TLFB) method. Secondary Aim will include
change in alcohol craving using the Penn Alcohol Craving Scale (PACS). Changes in psychiatric
symptoms (mania/hypomania and depression) and predictors of response will be assessed.
Participants with ≥ 1 drinking day at week 12 will be enrolled in a 4-week extension phase
with an upward titration to 30 mg/day for those in the active treatment group. The placebo
group will remain on placebo.
Subjects will be discontinued from the study if any of the following conditions occurs:
change in diagnosis to other than bipolar I or II disorder and AUD, development of active
suicidal or homicidal ideation with plan and intent, worsening in mood symptoms, that in the
opinion of the investigators requires discontinuation, pregnancy, development of severe or
life-threatening medical condition, involuntary psychiatric hospitalization or incarceration,
significant alcohol withdrawal (e.g. delirium tremens) based on clinical judgment (increases
in Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) scores will initiate a
careful clinical assessment of possible worsening of withdrawal symptoms), or cocaine or
amphetamine-positive urine drug screen during the study.
Inclusion Criteria:
- Outpatient men and women age 18-65 years old with bipolar I, II, Not Otherwise
Specified (NOS) disorder, or Schizoaffective Bipolar Type
- If diagnosed with Bipolar I, Bipolar NOS w/history of mania or Schizoaffective
Disorder Bipolar Type, current mood stabilizer therapy (lithium, valproic acid,
lamotrigine, gabapentin) with stable dose for > 28 days prior to randomization.
- Baseline Barrett Impulsiveness Scale-11 Score of > 62 (above average impulsivity)
- Systolic BP > 100 and < 165 and Diastolic BP > 60 and < 105 with no evidence of
orthostatic hypotension
- Current Diagnosis of Alcohol Use Disorder with at least moderate severity
- Alcohol use of an average of 15 drinks per 7 days in the past 28 days prior to intake
for men, and an average of 8 drinks per 7 day period in the past 28 days prior to
intake for women
- Current mood stabilizer therapy with stable dose for > 28 days
- Fluent in English or Spanish
Exclusion Criteria:
- Baseline Hamilton Rating Scale for Depression (HRSD) or Young Mania Rating Scale
(YMRS) scores > 35
- Mood disorders other than bipolar I, II, NOS or schizoaffective disorder bipolar type
(e.g. cyclothymic disorders, schizophrenia, schizoaffective disorder depressive type,
or unipolar depression based on the SCID), other disorders, e.g. anxiety disorders,
will be allowed.
- Current diagnosis of amphetamine or cocaine use disorder or a cocaine or amphetamine
positive baseline urine sample.
- Evidence of clinically significant alcohol withdrawal symptoms
- Current treatment with an atypical antipsychotic
- Current treatment with naltrexone, acamprosate, disulfiram, or topiramate in the last
28 days
- Prior treatment with Aripiprazole within the last year or lifetime history of
intolerable side effects to Aripiprazole
- Vulnerable populations (e.g. pregnant, nursing, cognitively impaired, incarcerated.)
- Evidence of clinically significant alcohol withdrawal symptoms defined as a CIWA-Ar
score of ≥ 10.
- High risk for suicide
- Aspartate Amino Transferase (AST) or Alanine Amino Transferase (ALT) > 3 times upper
limit of normal
- Current use of Cytochrome P450 3A4 inducing medication (e.g. carbamazepine, rifabutin,
rifampin, ritonavir).
- Use of other substances (besides cocaine/amphetamine) is allowed if the use disorder
is no greater than moderate severity and alcohol is the self-identified substance of
choice.
- History of neuroleptic malignant syndrome or tardive dyskinesia.
More specific inclusion and exclusion criteria will be discussed with participant at
baseline assessment.
We found this trial at
1
site
Dallas, Texas 75390
Principal Investigator: E. Sherwood Brown, MD, PhD
Phone: 2146456957
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