The purpose of this study is to evaluate the safety and efficacy of RTI-336 as a treatment for methamphetamine (METH) dependence in non-treatment-seeking METH-dependent volunteers.
Methamphetamine (METH) is a highly addictive stimulant and acute exposure causes dopamine (DA) release and stimulates midbrain reward centers. The proposed work represents an important research effort with considerable public health significance in that it will evaluate a compound targeted specifically at DA transporter (DAT) inhibition for the treatment of METH dependence. The knowledge gained may ultimately support development and implementation of evidence-based treatments for METH dependence, a drug abuse problem with tremendous public health impact. One therapeutic strategy is to develop and test compounds that normalize (increase) DA to determine if treatment with these drugs reduces METH use. A similar approach has been proposed as a treatment for cocaine dependence (Howell and Wilcox 2001; Mello and Negus 1996), another disorder associated with abnormally low DA activity (Martinez et al. 2007). In an effort to identify a DAT selective inhibitor, a number of 3-phenyltropane analogs were synthesized by RTI International. Among these, preclinical studies have shown that RTI-336 produced cocaine-like discriminative stimulus effects and reduced cocaine self-administration in rats, and produced dose-dependent suppression of cocaine self-administration in rhesus monkeys. RTI-336 recently received IND-approval (75,778) for preliminary safety testing in healthy male volunteers, and is scheduled to be completed by February 2009. Subsequent to this effort, RTI-336 will be evaluated in a phase I trial involving cocaine-dependent volunteers. The current application puts forth, for the first time, a proposal to evaluate the preliminary efficacy of this very promising candidate medication in non-treatment-seeking METH-dependent volunteers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Masking
QUADRUPLE
The effects of RTI-336 and methamphetamine on cardiovascular measures
Before and after each methamphetamine infusion during treatment with RTI-336, physiologic responses will be closely monitored using repeated HR, BP, and ECG readings. To evaluate safety, a DSMB will meet annually and following any serious AE to examine data as well as any new published information on RTI-336 relevant to the project. The number of AEs (including arrhythmias and ECG changes), changes in BP and HR, and changes in mood and psychiatric symptoms (using the BSI, BDI, POMS, and BPRS) will also be assessed throughout the study.
The effects of RTI-336 and methamphetamine on subjective measures
The ability of RTI-336 (1, 12 or 20 mg), as compared to placebo, to attenuate METH-induced (0 and 50 mg, IV) positive subjective effects (craving and ability to reduce reinforcing effects produced by methamphetamine) will be measured by: 1. VAS, Adjective Scales, and MCQ; 2. Choices for methamphetamine vs. money in the self-administration assay.
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