Allopregnanolone for Alcoholism

ER
IL
Overseen ByIsmene L Petrakis, MD
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether allopregnanolone (also known as Brexanolone or Zulresso) can reduce cravings and anxiety triggered by stress, particularly in heavy drinkers. The study will test the effects of allopregnanolone through an infusion and compare it to a placebo, which contains no active drug. Ideal participants are those with an alcohol use disorder who are not currently seeking treatment. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants a chance to contribute to groundbreaking research.

Will I have to stop taking my current medications?

You may need to stop taking certain medications to join this trial. Specifically, you cannot be on medications for alcoholism, sedating psychotropic medications, or antibiotics/antifungals.

Is there any evidence suggesting that this treatment is likely to be safe for humans?

Research has shown that allopregnanolone, similar to the drug brexanolone, has undergone safety testing. The FDA has approved brexanolone for treating postpartum depression. In studies, some participants experienced side effects such as drowsiness, dry mouth, or fainting. However, these side effects were uncommon. Thus, while some risks exist, many individuals tolerate the treatment well.12345

Why do researchers think this study treatment might be promising?

Most treatments for stress-induced cravings focus on behavioral therapy or medications that alter neurotransmitter activity, like SSRIs. But allopregnanolone works differently, targeting the brain's response to stress by acting on GABA receptors, which are crucial for calming neural activity. Researchers are excited about allopregnanolone because it’s a naturally occurring neurosteroid that may offer a more direct way to reduce cravings triggered by stress, potentially leading to faster and more effective relief compared to current options. Additionally, the infusion delivery method allows precise control over dosing, which could enhance its effectiveness and reduce side effects.

What evidence suggests that allopregnanolone might be an effective treatment for stress-induced craving and anxiety?

Research has shown that allopregnanolone, a compound similar to brexanolone, might help reduce cravings and anxiety caused by stress. Allopregnanolone influences certain parts of the brain that control mood. In this trial, participants will receive either an allopregnanolone infusion or a placebo. Brexanolone, a similar drug, successfully treated postpartum depression by greatly reducing symptoms. In clinical trials, brexanolone outperformed a placebo, suggesting that allopregnanolone might also be effective. These findings offer hope that allopregnanolone could help manage stress-related cravings and anxiety.56789

Who Is on the Research Team?

ER

Elizabeth Ralevski, PhD

Principal Investigator

Yale University

Are You a Good Fit for This Trial?

Inclusion Criteria

No current medical problems and normal ECG
For women, not pregnant as determined by pregnancy screening, not breast feeding
You cannot have an addiction to any drugs except for tobacco, alcohol, and marijuana.
See 1 more

Exclusion Criteria

weight >120kg
renal impairment
History of major medical illnesses; including liver diseases, heart disease, chronic pain or other medical conditions that the physician investigator deems contraindicated for the subject to be in the study
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a continuous infusion of allopregnanolone or placebo for 175 minutes, followed by stress induction paradigm

1 day
1 visit (in-person)

Follow-up

Participants are monitored for stress-induced craving and anxiety, as well as mood effects, cognitive performance, and motor coordination

1 day
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

  • Allopregnanolone
How Is the Trial Designed?
2Treatment groups
Active Control
Placebo Group
Group I: allopregnanoloneActive Control1 Intervention
Group II: placeboPlacebo Group1 Intervention

Allopregnanolone is already approved in United States for the following indications:

🇺🇸
Approved in United States as Zulresso for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Yale University

Lead Sponsor

Trials
1,963
Recruited
3,046,000+

National Institute on Alcohol Abuse and Alcoholism (NIAAA)

Collaborator

Trials
865
Recruited
1,091,000+

Citations

Brexanolone to Treat Postpartum Depression in Adult WomenIn two double blind clinical trials, brexanolone was shown to reduce depressive symptoms, demonstrated by reduced Hamilton Depression Rating Scale (HAM-D) ...
Real-World Outcomes of Brexanolone to Treat Postpartum ...FDA approved in August 2023, zuranolone demonstrated significant symptom improvement in two large, randomized trials, with effects observed as ...
NDA Multi-Disciplinary Review and Evaluation (ZULRESSO)characteristics, and efficacy results for adult studies used to substantiate evidence of efficacy for Zulresso. Table 8 and Table 9 compares ...
How do brexanolone and zuranolone compare in patients with ...Similarly, most patients in the brexanolone trials experienced an onset of PPD within 4 weeks postpartum (67% to 78%) and 17% to 26% of patients ...
Brexanolone (Zulresso) - Medical Clinical Policy BulletinsThe authors found that, in both studies, titration to a target dose of brexanolone 90 mcg/kg/hour was superior to placebo in improvement of depressive symptoms.
Post-Marketing Safety Data for Brexanolone (Zulresso)Because preliminary studies indicated that brexanolone may have potentially serious side effects, including excessive sedation and sudden loss ...
Safety of Brexanolone in Adults with Postpartum DepressionBrexanolone is currently the only medication approved by the US FDA for the treatment of postpartum depression (PPD) in patients ≥15 years.
Zulresso - accessdata.fda.govBased on findings from animal studies of other drugs that enhance GABAergic inhibition,. ZULRESSO may cause fetal harm. There are no available data on ZULRESSO ...
9.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37280463/
Safety of Brexanolone in Adults with Postpartum DepressionResults: Overall, 499 patients received brexanolone in this postmarketing surveillance analysis between June 2019 and December 2021 ( ...
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