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Completed

NCT Number: NCT05760807

Intranasal Oxytocin for Methamphetamine Withdrawal in Women

Methamphetamine use disorder (MUD) is a significant public health concern with burden to individuals, families and health systems estimated to cost over $5 billion annually in Australia. In 2016/17 there were 49,670 Australian treatment episodes for MUD, the first step of which typically involves inpatient withdrawal. Currently there are no approved medications to help manage methamphetamine withdrawal and consequently many people drop out of treatment prematurely, leaving them vulnerable to relapse.

Oxytocin is a candidate medication that has the potential to increase treatment retention, reduce withdrawal syndrome severity, increase post-withdrawal treatment engagement and reduce relapse rates.

The aim of this pilot study is to investigate whether intranasal oxytocin can improve withdrawal treatment outcomes in adult women with MUD. The study will examine the feasibility of intranasal oxytocin as a treatment for methamphetamine withdrawal in women. This will be explored by assessing length of stay in residential withdrawal, withdrawal symptom severity, post-discharge treatment engagement and relapse rates in a group of women who are prescribed intranasal oxytocin during their medically supervised methamphetamine withdrawal at a residential detoxification program. The safety of intranasal oxytocin will also be assessed. A secondary objective of the study is to conduct an exploratory analysis regarding participants' capacity to interact effectively with others, as well as changes in social networks and/or engagement with therapeutic services.

There is an observational sub-study affiliated with this main pilot study that is optional for individuals recruited to the main pilot trial to additionally participate in. This sub-study aims to investigate how sleep quality and patterns change before, during, and after detoxification from methamphetamine in women. MUD and sleep disturbances have a complex bidirectional relationship. The use of methamphetamine is known to disrupt sleep quality and the circadian rhythm, although withdrawal from methamphetamine also induces significant sleep-wake cycle changes. There is evidence that methamphetamine disrupts functions regulated by the circadian rhythm. Furthermore, disruptions in circadian rhythms, including mutations in key genes, increases the propensity for addiction. Evaluation of how chronic methamphetamine use may disrupt rhythmicity, and vice versa, may provide invaluable information with regard to potential treatment options of methamphetamine use disorder. There has been little focus, so far, on the therapeutic potential of circadian rhythm modifiers as treatment options in the addiction space, as sleep disturbances have often been merely viewed as a consequence of substance use.

Specific to the sub-study, participants will be asked to wear an actigraphy watch. The actigraphy watch device will be worn for at least 7 days prior to, 7 days during, and 7 days post methamphetamine detoxification. This is the only difference between the sub-study and the main pilot study; there are no other additional requirements or assessments involved in the actigraphy sub-study.

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Key information

Conditions

Methamphetamine Use Disorder

Age range

18 year–65 year

Sex eligibility

Female

Study type

Interventional

Phase

Not applicable

Primary location

Turning Point

Richmond, Victoria, 3121, Australia

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Adult females (sex assigned at birth) aged ≥18 to ≤65 years, admitted to the Turning Point Addiction Medicine Unit.
  • Meeting DSM-5 criteria for Methamphetamine Use Disorder, moderate or severe (assessed by treating physician on pre-admission to residential withdrawal).
  • Able to comply with study protocols.
  • Able to provide informed consent to participate.

Exclusion criteria

  • Non-English-speaking women.
  • Women lactating, pregnant or of childbearing potential who are not willing to use an effective means of contraception for the duration of the trial.
  • Meeting DSM-5 criteria for moderate-severe substance use disorder other than methamphetamine, nicotine and cannabis, as assessed by treating physician on pre-admission to residential withdrawal.
  • Clinically significant or unmanaged medical or psychiatric illness (e.g., renal insufficiency, cirrhosis, unstable hypertension, unstable diabetes mellitus, seizure disorder, history of DSM-5 psychotic or bipolar disorder, current severe major depression, current suicidal ideation), assessed by treating physician on pre-admission to residential withdrawal.
  • Current participation in another trial.

Treatment and study plan

Oxytocin nasal spray

Drug

Intranasal oxytocin, administered dose 24 international units (IU) twice daily, delivered over 7 days of a residential inpatient withdrawal admission.

Primary outcomes

  1. Feasibility assessment

    Time frame: Screening to Admission Day 1

    Feasibility assessment, as measured by the proportion of screen failures compared to those who received the study drug.

Secondary outcomes

  1. Length of stay in the inpatient withdrawal unit

    Time frame: Admission Day 1 to Admission Day 7

    Medical chart review to determine number of days stayed in the inpatient withdrawal unit.

  2. Methamphetamine withdrawal symptom severity

    Time frame: Admission Day 1 to Admission Day 7

    Individual average score across the participants' length of stay in the inpatient withdrawal unit on the Amphetamine Withdrawal Questionnaire (scores on this measure range from 0 to 40 with higher score indicating greater severity).

  3. Methamphetamine craving

    Time frame: Admission Day 1 to Admission Day 7

    Individual average score across the participants' length of stay in the inpatient withdrawal unit on the Visual Analogue Scale for Craving (scores on this measure range from 0 to 100, with higher scores indicating greater craving).

  4. Sleep dysfunction

    Time frame: Admission Day 1 to Admission Day 7

    Individual average score across the participants' length of stay in the inpatient withdrawal unit on the Insomnia Severity Index (scores on this measure range from 0 to 28, with higher scores indicating greater sleep dysfunction).

  5. Mood disturbance

    Time frame: Admission Day 1 to Admission Day 7

    Individual average score across the participants' length of stay in the inpatient withdrawal unit on the Abbreviated Profile of Mood States - Revised Version (total mood disturbance scores on this measure range from 0 to 116, with higher scores indicating greater disturbance)

  6. Methamphetamine relapse

    Time frame: 1-month post-discharge

    Relapse is defined as a yes/no result for any methamphetamine use in the month following discharge from the withdrawal unit, as assessed using the Timeline Follow Back measure.

  7. Treatment engagement

    Time frame: 1-month post-discharge

    Yes/No attendance at any form of treatment to assess treatment engagement at 1-month post-discharge.

  8. Therapeutic alliance

    Time frame: 1-month post-discharge

    Working Alliance Inventory-Short Form Revised will be used to assess therapeutic alliance with nominated primary provider (scores on this measure range from 12 to 60, with higher scores indicating better therapeutic alliance).

  9. Incidence of adverse events

    Time frame: Day 1 of admission to 1-month post-discharge

    Number and categorisation of reported adverse events.

  10. Perceived burden of intranasal oxytocin

    Time frame: Admission Day 1 to Admission Day 7

    Individual average score across the participants' length of stay in the inpatient withdrawal unit on the Visual Analogue Scale for Medication Utilisation Burden (scores on this measure range from 0 to 100, with higher scores indicating greater perceived burden).

  11. Perceived satisfaction with intranasal oxytocin

    Time frame: Admission Day 3 and 7

    Satisfaction with medication based on results from the Treatment Satisfaction Questionnaire (scores on this measure range from 0 to 100, with higher scores indicating greater satisfaction).

  12. Severity of Clinical Condition

    Time frame: Baseline to 1-month post-discharge

    Change in clinician-rated assessment of the participant's condition using the Clinical Global Impression - Severity Scale (scores on this measure range from 1 to 7, with higher scores indicating poorer condition).

  13. Improvement of Clinical Condition

    Time frame: 1-month post-discharge

    Clinician-rated assessment of the participant's overall clinical condition, substance use, and related problems compared to a baseline assessment, using the Clinical Global Impression - Improvement Scale (scores on this measure range from 5 to 35, with higher scores indicating a worsening of condition in comparison to baseline).

Other outcomes

  1. Change in facial emotion recognition

    Time frame: Baseline to 1-month post-discharge

    Change in total score on the Facial Emotion Recognition Task at 1-month post-discharge compared to baseline.

  2. Change in mentalisation

    Time frame: Baseline to 1-month post-discharge

    Change in total score on the Reading the Eyes in the Mind Task at 1-month post-discharge compared to baseline.

  3. Change in social functioning

    Time frame: Baseline to 1-month post-discharge

    Change in score on the Social Functioning Scale at 1-month post-discharge compared to baseline (scores on this measure range from 0 to 24, with higher scores indicating poorer social functioning).

  4. Sleep-wake cycles [part of the optional sub-study]

    Time frame: 7 days prior to, 7 days during, and 7 days post methamphetamine detoxification.

    Change in sleep-wake cycles, as assessed via actigraphy monitoring, before, during and after methamphetamine detoxification.

  5. Objective assessment of sleep quality [part of the optional sub-study]

    Time frame: 7 days prior to, 7 days during, and 7 days post methamphetamine detoxification.

    Change in sleep quality, as assessed via actigraphy monitoring, before, during and after methamphetamine detoxification.

  6. Objective assessment of sleep duration [part of the optional sub-study]

    Time frame: 7 days prior to, 7 days during, and 7 days post methamphetamine detoxification.

    Change in sleep duration, as assessed via actigraphy monitoring, before, during and after methamphetamine detoxification.

  7. Subjective sleep quality

    Time frame: Baseline to 1-month post-discharge.

    Change in score on the Pittsburgh Sleep Quality Index at 1-month post-discharge compared to baseline (scores on this measure range from 0 to 21, with higher scores indicating poorer sleep quality).

  8. Rhythmicity of sleep-wake cycles

    Time frame: Baseline to 1-month post-discharge.

    Sleep rhythmicity and categorisation of morning-evening preference grouping using the Morningness-Eveningness Questionnaire-Reduced Scale (scores on this measure range from 4-25, where higher scores are indicative of morning-type preferences - scores are categorised into one of 5 preference groups, ranging from "Definitely Evening Type" to "Definitely Morning Type").

Sponsors and collaborators

Lead sponsor

Turning Point

Other

Collaborators

  • Eastern Health
  • Monash University
  • National Centre for Clinical Research on Emerging Drugs (NCCRED)

Registry information

Official study title

An Open Label Pilot Study of Intranasal Oxytocin for Methamphetamine Withdrawal in Women

Acronym: mOXY

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Mar 8, 2023
Registry last updated
Apr 11, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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