The Imperial College Cambridge Manchester (ICCAM) platform study: An experimental medicine platform for evaluating new drugs for relapse prevention in addiction. Part A: Study description

J Psychopharmacol. 2015 Sep;29(9):943-60. doi: 10.1177/0269881115596155. Epub 2015 Aug 5.

Abstract

Drug and alcohol dependence are global problems with substantial societal costs. There are few treatments for relapse prevention and therefore a pressing need for further study of brain mechanisms underpinning relapse circuitry. The Imperial College Cambridge Manchester (ICCAM) platform study is an experimental medicine approach to this problem: using functional magnetic resonance imaging (fMRI) techniques and selective pharmacological tools, it aims to explore the neuropharmacology of putative relapse pathways in cocaine, alcohol, opiate dependent, and healthy individuals to inform future drug development. Addiction studies typically involve small samples because of recruitment difficulties and attrition. We established the platform in three centres to assess the feasibility of a multisite approach to address these issues. Pharmacological modulation of reward, impulsivity and emotional reactivity were investigated in a monetary incentive delay task, an inhibitory control task, and an evocative images task, using selective antagonists for µ-opioid, dopamine D3 receptor (DRD3) and neurokinin 1 (NK1) receptors (naltrexone, GSK598809, vofopitant/aprepitant), in a placebo-controlled, randomised, crossover design. In two years, 609 scans were performed, with 155 individuals scanned at baseline. Attrition was low and the majority of individuals were sufficiently motivated to complete all five sessions (n=87). We describe herein the study design, main aims, recruitment numbers, sample characteristics, and explain the test hypotheses and anticipated study outputs.

Keywords: Addiction; dopamine D3 receptor; functional magnetic resonance imaging; neurokinin 1 receptor; µ-opioid receptor.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Behavior, Addictive / metabolism
  • Behavior, Addictive / prevention & control*
  • Biomedical Research / methods*
  • Brain / drug effects
  • Brain / metabolism
  • Cocaine / adverse effects
  • Cross-Over Studies
  • Drug Discovery / methods
  • Ethanol / adverse effects
  • Female
  • Humans
  • Impulsive Behavior / drug effects
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Naltrexone / metabolism
  • Neurokinin-1 Receptor Antagonists / therapeutic use
  • Pharmaceutical Preparations / administration & dosage*
  • Receptors, Dopamine D3 / antagonists & inhibitors
  • Receptors, Dopamine D3 / metabolism
  • Receptors, Neurokinin-1 / metabolism
  • Reward
  • Secondary Prevention / methods*
  • Substance-Related Disorders / drug therapy*
  • Substance-Related Disorders / metabolism
  • Substance-Related Disorders / prevention & control*

Substances

  • Neurokinin-1 Receptor Antagonists
  • Pharmaceutical Preparations
  • Receptors, Dopamine D3
  • Receptors, Neurokinin-1
  • Ethanol
  • Naltrexone
  • Cocaine