Heroin Dependence
Conditions
Keywords
Heroin dependence, transcranial magnetic stimulation, cognitive behavioral therapy
Brief summary
Heroin dependence is one of most common substance dependence, which brings great burden on health worldwide. Heroin dependence may lead to immunosuppression and cognitive impairments. Once heroin dependence is developed, it will be difficult to recover and easy to relapse. Although many efforts had been made in the treatment of heroin dependence, the annual recurrence of heroin dependence with traditional therapies would be up to 90%. Repetitive transcranial magnetic stimulation (rTMS) on the dorsolateral prefrontal cortex (DLPFC) or cognitive behavioral therapy (CBT) each alone was reported to have some effect on preventing from relapse of substance dependence. In order to test whether combined therapy of high frequency rTMS (hf-rTMS) with CBT is better for preventing from relapse of heroin dependence, we recruit patients with heroin dependence to participate this study. The study is a factorial designed and the patients will be assigned into one of the following six groups randomly: (1) regular treatment (symptomatic treatment) with blank TMS; (2) regular treatment (RT) with blank TMS and CBT; (3) RT with right DLPFC hf-rTMS; (4) RT with right DLPFC hf-rTMS and CBT; (5) RT with left DLPFC hf-rTMS; (6) RT with left DLPFC hf-rTMS and CBT. TMS was given 5 days per week for total 2 weeks using uniform scheme (5 seconds of 10Hz stimulation per train, 30 trains per day with inter-train interval of 20 seconds). CBT will be given once per week for total 8 weeks. The patients will be followed up for 6 months. Recurrence of heroin dependence, duration of abstention, heroin/drug intake, craving for heroin and other cognitive psychological assessments will be recorded and compared among the 6 treatment groups and the efficacy of combined therapy of rTMS with CBT will be evaluated in our study.
Interventions
COMBINATION_PRODUCTTranscranial magnetic stimulation and Cognitive behavioral therapy
Transcranial magnetic stimulation on different side with/without cognitive behavioral therapy
Sponsors
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Diagnosis as heroin dependence according to DSM-IV criteria * No definite history of neurological diseases and psychological problems * Volunteer to participate the study, cooperate to be followed up
Exclusion criteria
* Acute withdrawal state and CIWA score \> 9 * With other neurological diseases and psychological problems * With ever brain trauma and damage * With other psychological medications or other substance dependence * With other contraindications to have transcranial magnetic stimulation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Recurrence of heroin dependence | 1 month | The rate of relapse of heroin dependence after discharge from hospital |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Psychological assessment - Anxiety | 2 weeks, 1 month, 2 months, 3 months and 6 months | Psychological assessment by Generalized Anxiety Disorder-7 (GAD-7) ranging from 0 to 21. Higher score indicates more severer anxiety. |
| Psychological assessment - Depression | 2 weeks, 1 month, 2 months, 3 months and 6 months | Psychological assessment by Patient Health Questionnaire-9 (PHQ-9) ranging from 0 to 27. Higher score indicates more severer depression. |
| Psychological assessment - Sleep | 2 weeks, 1 month, 2 months, 3 months and 6 months | Psychological assessment by Pittsburgh Sleep Quality Index (PSQI) ranging from 0 to 21. Higher score indicates worse sleep. |
| Cognitive assessment | 2 weeks, 1 month, 2 months, 3 months and 6 months | Cognitive assessment by Montreal Cognitive Assessment (MoCA) ranging from 0 to 30. Lower score indicates worse cognitive function. |
| Heroin consumption | 2 weeks, 1 month, 2 months, 3 months and 6 months | Diaries of heroin intake in different time of the follow-ups |
| Craving for heroin | 2 weeks, 1 month, 2 months, 3 months and 6 months | Craving assessment for heroin by Heroin Craving Questionnaire (HCQ) ranging from 0 to 175. Higher score of HCQ indicates more desire for heroin. |
| Duration of abstinence | 6 months | The total time or period without any intake of heroin during follow-ups |
Countries
China
Contacts
Primary ContactYing Peng, MD, PhD
Backup ContactHongxuan Wang, MD, PhD
Outcome results
None listed