LSD Treatment for Persons With Alcohol Use Disorder

Phase 2Not Yet RecruitingNCT05474989

Felix Mueller126 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Eligibility

Sex: ALLMin age: 25 Years

Medical Language ↔ Plain English

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

Outcomes

Primary Outcomes

Percent heavy drinking days

The primary outcome is the mean of percent heavy drinking days after administration of two doses of LSD assessed with the alcohol timeline follow-back (TLFB) questionnaire compared between treatment groups

Time frame: Period of three months after the second intervention

Secondary Outcomes

Cortical thickness measured with MRI

Changes in the cortical thickness of ACC, PCC, and PFC

Time frame: Two weeks before first administration, two and 12 weeks after second administration

The volume of the striatum measured with MRI

Changes in the volume of the striatum

Time frame: Two weeks before first administration, two and 12 weeks after second administration

White matter microstructure measured with MRI

Changes in white matter microstructure in the cingulum bundle and the PFC-striatal connection pathway

Time frame: Two weeks before first administration, two and 12 weeks after second administration

Days to first heavy drinking day

Days to first heavy drinking day after first and second administration assessed with TLFB

Time frame: Three months after the second intervention

Days to first drinking day

Days to first drinking day assessed after first and second administration assessed with TLFB

Time frame: Three months after the second intervention

Percent days abstinent

Percent days abstinent after first and second administration assessed with TLFB

Time frame: Three months after the second intervention

Drinks per drinking day

Drinks per drinking day after first and second administration assessed with TLF

Time frame: Three months after the second intervention

Adverse consequences of alcohol use

Adverse consequences of alcohol use assessed with Short Inventory of Problems

Time frame: Three months after the second intervention

Craving

Craving assessed with Obsessive Compulsive Drinking Scale

Time frame: Three months after the second intervention

Ethyl glucuronide

Ethyl glucuronide (EtG) in hair

Time frame: Screening and three months after the second intervention

Phosphatidylethanol

Phosphatidylethanol (PEth) in blood

Time frame: Screening, day of first intervention, day of second intervention, three months after the second intervention

General health

General health assessed with General Health Questionnaire

Time frame: Three months after the second intervention

Depression

Hamilton Depression Rating Scale

Time frame: Three months after the second intervention

Anxiety

Beck Anxiety Inventory

Time frame: Three months after the second intervention

Blinding

Blinding will be assessed directly after each session by asking patients and therapists to guess the group assignment ("high dose", "low dose", "don't know") and to provide their degree of certainty (using a visual analogue scale) of their guess.

Time frame: In the evening after administration 1 (week 4) and administration 2 (week 8), respectively

Safety: Adverse events

Adverse events will be documented at each visit and each session.

Time frame: Week 0 to week 20

LSD Treatment for Persons With Alcohol Use Disorder

Overview

Conditions

Interventions

Eligibility

Locations (2)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts