Neural Mechanisms of Disulfiram Effects

• Status: Completed
• Trial end date: 2020-10-16
• Target enrollment: 0
• Participant gender: All

Summary

This study combines functional MRI with medication treatment in order to understand the neural mechanisms by which disulfiram, a currently approved medication for alcohol use disorder, changes behavior. Disulfiram is a medication that prevents drinking by causing a highly unpleasant physical reaction when alcohol is consumed while it is being taken. Thus, it provides a means for studying the general neural mechanisms by which awareness of risks impacts behavior change in alcohol use disorder.

• Phase: Phase 4
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: New York State Psychiatric Institute
• Treatments: Disulfiram; Ethanol

Criteria

Inclusion Criteria:

1. Between the ages of 21-60

2. Right-handed

3. Capable of giving informed consent and complying with study procedures

4. Reports drinking a minimum of 5 standard drinks for men or 4 standard drinks for women on at least 4 days per week on average over the past 28 days

5. Meets DSM-V criteria for current Alcohol Use Disorder

6. Seeking treatment for Alcohol Use Disorder

7. Agree to not seek additional treatment, apart from Alcoholics Anonymous

8. Willing to attempt to abstain from alcohol completely for the duration of the study

9. Willing to be hospitalized on a research unit for 24 hours, longer if detoxification is needed.

Exclusion Criteria:

1. Risk of severe alcohol withdrawal (e.g. history of seizures or delirium tremens)

2. Current Moderate or Severe Substance Use Disorder, other than Alcohol, Nicotine or Caffeine Use Disorders

3. Lifetime history of Bipolar Disorder, Schizophrenia or Schizoaffective Disorder

4. Any current psychiatric disorder, other than Alcohol Use Disorder, that, in the judgment of the investigator, will require treatment that will interfere with study participation.

5. Current severe depression (HAM-D >24) or anxiety (HAM-A >24)

6. Significant suicide or violence risk

7. Currently taking any psychotropic medications

8. Legally mandated to participate in treatment

9. History of prior treatment with disulfiram

10. Sufficiently socially unstable as to preclude participation (e.g. homeless)

11. Contraindications to disulfiram treatment (liver disease, kidney disease, cardiac disease, seizure disorder, hypothyroidism, diabetes mellitus, pregnancy or lactation, allergy to disulfiram or thiuran derivatives)

12. Neurological or medical conditions that would interfere with MRI scanning (e.g. history of stroke, seizure, brain tumor, brain infection, traumatic brain injury, multiple sclerosis, dementia, metal device in body, pregnancy, claustrophobia, color blindness, severe hearing impairment, weight>300 lbs., wheelchair-bound)

13. Currently taking medications containing alcohol, metronidazole, isoniazid, paraldehyde, phenytoin, warfarin, or theophylline.

14. Significant alcohol withdrawal (CIWA>8) at screening, after confirming a blood alcohol level of zero.