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Completed

NCT Number: NCT01954966

Progesterone and Brain Imaging Study

Male and female smokers were recruited to undergo 2 phases of smoking cessation. Each phase was 4 days long and involved 3 brain-imaging scans, blood draws and an intervention involving progesterone or a matched placebo.

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Key information

Conditions

Nicotine Dependence Behavior Chemically-Induced Disorders Mental Disorders Nicotine Withdrawal Smoking Substance-Related Disorders Tobacco Use Disorder

Age range

18 year–50 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 4

Primary location

Penn Center for Women's Behavioral Wellness

Philadelphia, Pennsylvania, 19104, United States

About this study

The purpose of this study is to learn whether a sex hormone called progesterone is helpful in reducing cigarette smoking and craving for cigarettes. This study also includes brain imaging to measure possible effects of progesterone on certain neurochemicals. These neurochemicals are called gamma-aminobutyric acid (or GABA for short) and glutamate. Both nicotine and progesterone affect these brain chemicals.

Individuals wishing to participate in this study must be medically healthy men or women who smoke at least 10 cigarettes per day or greater. Participants must not suffer from a mental illness or use drugs other than nicotine and marijuana. Participants cannot have any implanted metallic devices such as pacemakers, orthodontic braces, or shrapnel. Participants must not have peanut allergies and must never have had a reaction to progesterone. Finally, participants cannot be taking any medications for anxiety, depression or insomnia.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Female and male smokers, aged 18 to 50 years;
  • History of smoking greater than or equal to 10 cigarettes daily for the past year, as per self-report (periods of smoking abstinence within the last year will be exclusionary at PI discretion);
  • Not seeking treatment at the time of the study for nicotine dependence;
  • Have a Fagerstrom Test for Nicotine Dependence (FTND) score of at least 3 and a Carbon Monoxide (CO) level greater than or equal to 11 ppm;
  • Clean urine drug screen (marijuana is permissible);
  • In good health as verified by medical history;
  • For women, not pregnant as determined by pregnancy screening, nor breast feeding.

Exclusion criteria

  • History of major medical illness: including liver diseases, abnormal vaginal bleeding, suspected or known malignancy; thrombophlebitis; deep vein thrombosis; pulmonary embolus; clotting or bleeding disorders; heart disease; diabetes; history of stroke or other medical conditions that the physician investigator deems as contraindicated for the patient to be in the study;
  • Regular use of psychotropic medication (antidepressants, antipsychotics, or anxiolytics) and recent (within previous year) psychiatric diagnosis and treatment for Axis I disorders including major depression, bipolar affective disorder, generalized anxiety disorder, post-traumatic stress disorder and panic disorder;
  • Lifetime history of schizophrenia or other psychotic disorder;
  • Lifetime substance dependence disorder, excepting nicotine, alcohol and marijuana, as per SCID interview
  • Substance use disorders within the previous 2 years, excepting nicotine, as per SCID interview
  • Regular use of any other tobacco products than cigarettes, including smokeless tobacco and nicotine products;
  • Known allergy to progesterone or peanuts (vehicle for micronized progesterone).

Treatment and study plan

Progesterone

Drug

Participants will consume four pills of Progesterone over a period of four days. Participants will be asked to remain abstinent from smoking while taking Progesterone.

Other names: Prometrium

Placebo

Drug

Participants will consume four pills of Placebo over a period of four days. Participants will be asked to remain abstinent from smoking while taking Placebo.

Primary outcomes

  1. GABA Pre and Post Progesterone Administration (Dorsal Anterior Cingulate Cortex [DACC])

    Time frame: Test Day #2 and Test Day #5 - 6 total scans over the period of 2-3 months.

    GABA concentrations (collected in the Dorsal Anterior Cingulate Cortex [DACC]) will be obtained using the non-invasive neuroimaging method of proton magnetic resonance spectroscopy (1H-MRS) both before and after placebo administration and smoking abstinence. In total subjects will undergo 6 1H-MRS scans. The 6 1H-MRS scans take place over a period of approximately 1-2 months. Each paradigm (placebo/progesterone) takes approximately one week, with an approximately two-week wash in between paradigms for men and an approximately 1-month wash in between paradigms for women. The subject will undergo a smoking session on Test Day #1 and Test Day #5, MRS scans are conducted on Test Day #2 (2 scans) and Test Day #5 (1 scan).

    Minimal data is available for the primary outcome due to substantial issues with the 7T scanner. All subsequent scans were conducted on a 3T scanner which does not have the capacity to collect data on GABA.

  2. GABA Pre and Post Progesterone Administration (Dorsolateral Pre-Frontal Cortex [DLPFC])

    Time frame: Test Day #2 and Test Day #5 - 6 total scans over the period of 2-3 months.

    GABA concentrations (collected in the Dorsolateral Pre-Frontal Cortex [DLPFC]) will be obtained using the non-invasive neuroimaging method of proton magnetic resonance spectroscopy (1H-MRS) both before and after placebo administration and smoking abstinence. In total subjects will undergo 6 1H-MRS scans. The 6 1H-MRS scans take place over a period of approximately 1-2 months. Each paradigm (placebo/progesterone) takes approximately one week, with an approximately two-week wash in between paradigms for men and an approximately 1-month wash in between paradigms for women. The subject will undergo a smoking session on Test Day #1 and Test Day #5, MRS scans are conducted on Test Day #2 (2 scans) and Test Day #5 (1 scan).

    Minimal data is available for the primary outcome due to substantial issues with the 7T scanner. All subsequent scans were conducted on a 3T scanner which does not have the capacity to collect data on GABA.

Secondary outcomes

  1. Symptoms During Nicotine Abstinence (NWSC)

    Time frame: Day 1 (pre and post smoking session, day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Withdrawal symptoms will be measured using the Nicotine Withdrawal Symptoms Checklist (NWSC). The scale ranges from a minimum of 0 to a maximum of 28, with higher scores indicating greater withdrawal (more withdrawal symptoms, higher intensity/severity of withdrawal).

  2. Brief Questionnaire on Smoking Urges (BQSU)

    Time frame: Day 1 (pre and post smoking session, day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Craving will be assessed using the Brief Questionnaire on Smoking Urges (BQSU). It ranges from 7-70 with higher levels indicating higher levels of nicotine craving.

  3. Tiffany Questionnaire on Smoking Urges (TQSU)

    Time frame: Day 1 (pre smoking session, day 3 (PM), day 4 (PM), day 5 (pre smoking session)

    Craving will also be assessed using the Tiffany Questionnaire for Smoking Urges. It ranges from 32 to 224 with higher scores indicated higher levels of smoking urges/craving.

  4. Profile of Mood States (POMS) Subscale: Tension-Anxiety

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood States (POMS) Subscale: Tension-Anxiety. This subscale ranges from 0-28 with higher levels indicating greater tension/anxiety.

  5. Profile of Mood States (POMS) Subscale: Depression-Dejection

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood States (POMS) Subscale: Depression-Dejection. This subscale ranges from 0-60 with higher levels indicating greater depression/dejection.

  6. Profile of Mood States (POMS) Subscale: Anger-Hostility

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood States (POMS) Subscale: Anger-Hostility. This scale ranges from 0 to 48 with higher levels indicating higher levels of anger/hostility.

  7. Profile of Mood States (POMS) Subscale: Fatigue

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood States (POMS) Subscale: Fatigue. This subscale ranges from 0 to 28 with higher scores indicating higher levels of fatigue.

  8. Profile of Mood State (POMS) Subscale: Vigor

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood State (POMS) Subscale: Vigor. Subscale ranges from 0 to 32, with higher levels indicating higher levels of vigor.

  9. Profile of Mood States (POMS) Subscale: Confusion-Bewilderment

    Time frame: Day 2 (pre and post scan), Day 5 (pre smoking session)

    Profile of Mood States (POMS) Subscale: Confusion-Bewilderment. Ranges from 0 to 28 with higher levels indicating higher levels of confusion/bewilderment.

  10. Visual Analog Scale (VAS) Question: Headache

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Headache. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  11. Visual Analog Scale (VAS) Question: Hunger

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Hunger. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  12. Visual Analog Scale (VAS) Question: Nauseous

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Nauseous. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  13. Visual Analog Scale (VAS) Question: Heartburn.

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Heartburn. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  14. Visual Analog Scale (VAS) Question: Tired

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Tired. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  15. Visual Analog Scale (VAS) Question: Irritable

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Irritable. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  16. Visual Analog Scale (VAS) Question: Energetic

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Energetic. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  17. Visual Analog Scale (VAS) Question: Relaxed

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Relaxed. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  18. Visual Analog Scale (VAS) Question: Talkative

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Headache. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  19. Visual Analog Scale (VAS) Question: Happy

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Happy. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  20. Visual Analog Scale (VAS) Question: Nervous

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Nervous. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  21. Visual Analog Scale (VAS) Question: Sad

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Sad. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  22. Visual Analog Scale (VAS) Question: Calm

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Calm. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  23. Visual Analog Scale (VAS) Question: Depressed

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Depressed. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  24. Visual Analog Scale (VAS) Question: Drowsy

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Drowsy. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  25. Visual Analog Scale (VAS) Question: Anxious

    Time frame: Day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Visual Analog Scale (VAS) question: Anxious. Scale ranges from 0 to 100 with higher levels indicating greater intensity of symptom/feeling.

  26. Positive and Negative Affect Schedule (PANAS) Negative Affect

    Time frame: Day 1 (pre and post smoking session, day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Positive and Negative Affect Schedule (PANAS) Negative Affect Score. Ranges from 10-50 with higher scores representing higher levels of negative affect.

  27. Positive and Negative Affect Schedule (PANAS) Positive Affect

    Time frame: Day 1 (pre and post smoking session, day 2 (pre and post scan), day 3 (AM and PM), day 4 (AM and PM), day 5 (pre and post smoking session)

    Positive and Negative Affect Schedule (PANAS) Positive Affect Score. Ranges from 10-50 with higher scores representing higher levels of positive affect.

  28. Nicotine Effects Questionnaire (NEQ) Question: Feels Strength of Nicotine

    Time frame: Day 1 (pre smoking session), Day 5 (post smoking session)

    Nicotine Effects Questionnaire (NEQ) question: feels strength of nicotine. Score ranges from 0 to 100 with higher levels indicating feeling stronger effects of nicotine after smoking.

  29. Nicotine Effects Questionnaire (NEQ) Question: Feels Good Effects of Nicotine

    Time frame: Day 1 (pre smoking session), Day 5 (post smoking session)

    NEQ question: feels good effects of nicotine. Score ranges from 0 to 100 with higher levels indicating feeling more good effects of nicotine after smoking.

  30. Nicotine Effects Questionnaire (NEQ) Question: Feels Bad Effects of Nicotine

    Time frame: Day 1 (pre smoking session), Day 5 (post smoking session)

    Nicotine Effects Questionnaire (NEQ) question: feels bad effects of nicotine. Score ranges from 0 to 100 with higher levels indicating feeling more bad effects of nicotine after smoking.

  31. Nicotine Effects Questionnaire (NEQ) Question: Head Rush

    Time frame: Day 1 (pre smoking session), Day 5 (post smoking session)

    Nicotine Effects Questionnaire (NEQ) question: feels head rush. Score ranges from 0 to 100 with higher levels indicating feeling stronger/more intense head rush after smoking.

Sponsors and collaborators

Lead sponsor

University of Pennsylvania

Other

Collaborators

  • National Institute on Drug Abuse (NIDA)

Registry information

Official study title

Multimodal Imaging of Progesterone/Neurosteroid Effects in Nicotine Addiction

Important dates

Study start
2010
Primary completion
2021
Study completion
2021
First posted
Oct 7, 2013
Registry last updated
Jul 5, 2022

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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