Low-dose MDMA as a stimulation test for a possible oxytocin deficiency in patients with vasopressin deficiency and healthy controls
Descrizione riassuntiva dello studio
Arginine-vasopressin (AVP) and oxytocin (OXT) are neuropeptides consisting of nine amino acids and are released from the posterior pituitary gland. A disturbed hypothalamic-pituitary axis can lead to AVP deficiency, formerly known as central diabetes insipidus (cDI). A disturbed AVP system could also disrupt the OXT system and lead to OXT deficiency. Provocation tests exist for other pituitary hormones, but there is no standardized test for OXT. Physiological stimuli or common tests have not shown a consistently strong increase in OXT levels. 3,4-methylenedioxymethamphetamine (MDMA) is used for its empathy-enhancing effects. Several studies documented significant increases in OXT levels in response to MDMA in healthy adults. In a pilot study, we showed that 100 mg of MDMA increased plasma OXT levels in healthy controls by eightfold, while no increase was observed in AVP-deficient patients. These results suggested an OXT deficiency in AVP-deficient patients. However, 100 mg of MDMA led to acute mood effects and mild cardiostimulatory effects, complicating its clinical application as a test. Since MDMA is the most promising stimulation test, we are now investigating whether lower doses of 25 mg or 50 mg of MDMA also induce a strong OXT stimulation with minimal side effects. We hypothesize that low-dose MDMA induces a strong OXT stimulation in healthy controls and no relevant increase in patients. This study will confirm our previous data and provide important safety data on low-dose MDMA.
(BASEC)
Intervento studiato
Case-control study with a randomized, double-blind, controlled crossover design (MDMA 50 mg versus 25 mg versus placebo, intra-individual comparison) in patients versus healthy controls (inter-individual comparison).
(BASEC)
Malattie studiate
Patients with vasopressin deficiency (central diabetes insipidus)
(BASEC)
Inclusion criteria for patients: -Confirmed diagnosis of arginine-vasopressin deficiency (central diabetes insipidus) Inclusion criteria for healthy controls: -Healthy volunteers -Matched for age, sex, BMI, and estrogen replacement/menopause/hormonal contraceptives to the patients -No medications, except hormonal contraception (BASEC)
Criteri di esclusione
Exclusion criteria: 1. Participation in a study with investigational drugs within the last 30 days 2. Use of illegal substances (except cannabis) more than 10 times in life or at any time in the last two months 3. Consumption of alcoholic beverages >15 drinks/week 4. Smoking >10 cigarettes/day 5. Cardiovascular diseases (coronary artery disease, heart failure LVEF <40%, stroke in the last 3 months, atrial fibrillation/flutter, WPW syndrome) 6. Uncontrolled arterial hypertension (>140/90 mmHg) or hypotension (<85 mmHg) (BASEC)
Luogo dello studio
Basilea
(BASEC)
Sponsor
Mirjam Christ-Crain
(BASEC)
Contatto per ulteriori informazioni sullo studio
Persona di contatto in Svizzera
Prof. Dr. Mirjam Christ-Crain
+41 61 265 25 25
mirjam.christ-crain@clutterusb.chUniversity Hospital Basel
(BASEC)
Informazioni generali
University Hospital, Basel, Switzerland,
+41 61 265 25 25;+41 61 265 25 25
mirjam.christ-crain@clutterusb.ch(ICTRP)
Informazioni generali
University Hospital, Basel, Switzerland
+41 61 265 25 25+41 61 265 25 25
mirjam.christ-crain@clutterusb.chmirjam.christ-crain@clutterusb.ch(ICTRP)
Informazioni scientifiche
University Hospital, Basel, Switzerland,
+41 61 265 25 25;+41 61 265 25 25
mirjam.christ-crain@clutterusb.ch(ICTRP)
Nome del comitato etico approvante (per studi multicentrici solo il comitato principale)
Commissione d'etica svizzera nord-ovest/centrale EKNZ
(BASEC)
Data di approvazione del comitato etico
23.07.2024
(BASEC)
ID di studio ICTRP
NCT06789705 (ICTRP)
Titolo ufficiale (approvato dal comitato etico)
Plasma oxytocin changes in response to low-dose MDMA vs. placebo in patients with arginine vasopressin deficiency (central diabetes insipidus) and healthy controls – the OxyMAX Study (BASEC)
Titolo accademico
Plasma Oxytocin Changes in Response to Low-dose MDMA vs. Placebo in Patients With Arginine Vasopressin Deficiency (Central Diabetes Insipidus) and Healthy Controls - the OxyMAX Study (ICTRP)
Titolo pubblico
Plasma Oxytocin Changes in Response to Low-dose MDMA vs. Placebo in Patients With Arginine Vasopressin Deficiency and Healthy Controls (ICTRP)
Malattie studiate
Central Diabetes Insipidus (ICTRP)
Intervento studiato
Drug: MDMAOther: Placebo (ICTRP)
Tipo di studio
Interventional (ICTRP)
Disegno dello studio
Allocation: Randomized. Intervention model: Crossover Assignment. Primary purpose: Treatment. Masking: Double (Participant, Investigator). (ICTRP)
Criteri di inclusione/esclusione
Inclusion criteria patients:
1. Adult patients with confirmed diagnosis of Arginine Vasopressin deficiency (central
diabetes insipidus)2 or with only anterior pituitary deficiency
Inclusion criteria healthy controls:
1. Adult healthy controls
2. Matched for age, sex, Body mass index, and oestrogen replacement/menopause/hormonal
contraceptives to patients
3. No medication, except hormonal contraception
Exclusion Criteria:
1. Participation in a trial with investigational drugs within 30 days
2. Illicit substance use (except for cannabis) more than 10 times in lifetime or any
time within the previous two months
3. Consumption of alcoholic beverages >15 drinks/week
4. Tobacco smoking >10 cigarettes/day
5. Cardiovascular disease (coronary artery disease, heart failure Left ventricular
ejection fraction <40%, stroke in the last 3 months, atrial fibrillation/flatter,
Wolff-Parkinson-White-Syndrome)
6. Uncontrolled arterial hypertension (>140/90 mmHg) or hypotension (<85mmHg)
7. Current or previous major psychiatric disorder (e.g., major depression,
schizophrenia spectrum disorder)
8. Psychotic disorder in first-degree relatives
9. Regular intake of selective serotonin reuptake inhibitors or Monoamine oxidase
inhibitors
10. Pregnancy and breastfeeding
11. Diagnosed Chronic Kidney Disease > grade III (glomerular filtration rate < 30ml/min)
12. Diagnosed liver cirrhosis or alanine aminotransferase (ALAT) or aspartate
aminotransferase (ASAT) levels 2.5 times above the normal range (ICTRP)
non disponibile
Endpoint primari e secondari
Area under the concentration-time curve in plasma oxytocin level (ICTRP)
Peak change in oxytocin plasma level;Time course of plasma oxytocin levels;Time course of plasma MDMA concentration;Subjective/emotional effects assessed on numeric analogue scales (NASs);Recognition of emotions and body expressions in the Emotion from Body expression and Emotion from Face (EmBody/EmFace) task;Recognition of emotions and body expressions in the face emotion recognition task (FERT);Anxiety level with the State-Trait Anxiety Inventory (STAI-S);Anxiety level with the State-Trait Anxiety Inventory (STAI-T);Number of complaints;Number of adverse effects;Time course of plasma copeptin;Time course of plasma Adrenocorticotropic hormone (ACTH);Time course of plasma cortisol;Time course of plasma prolactin;Time course of plasma neurophysin I;Alexithymia level using the Toronto-Alexithymia-Scale 20 (TAS-20);Depression level using the Beck-Depressions-Inventory II (BDI-II);General physical & mental health using the posterior-pituitary quality of life questionnaire (PP-QoL);General physical & mental health using the Patient-Reported Outcomes Measurement Information System (PROMIS);Autistic traits level using the Autism-Spectrum Quotient Test (AQ);Eating disturbances level using the Three-Factor Eating Questionnaire-Revised 18 Item (TFEQ-R18);Resting energy expenditure (REE) in kcal per 24 hours, time course of plasma glucose, insulin and c-peptide, subjective saturation effects assessed on a 10-point NAS.;Time course of plasma glucose;Time course of plasma insulin;Time course of plasma c-peptide;Subjective saturation effects;Assessments of clinical variable blood pressure;Assessments of clinical variable heart rate;Assessments of clinical variable body temperature;Assessments of laboratory variable plasma sodium;Assessments of laboratory variable potassium (ICTRP)
Data di registrazione
non disponibile
Inclusione del primo partecipante
non disponibile
Sponsor secondari
non disponibile
Contatti aggiuntivi
Mirjam Christ-Crain, Prof.;Mirjam Christ-Crain, Prof.;Mirjam Christ-Crain, Prof., Mirjam.Christ-Crain@usb.ch, +41 61 265 25 25;+41 61 265 25 25, University Hospital, Basel, Switzerland, (ICTRP)
ID secondari
2024-01105, kt24ChristCrain3 (ICTRP)
Risultati-Dati individuali dei partecipanti
non disponibile
Ulteriori informazioni sullo studio
https://clinicaltrials.gov/ct2/show/NCT06789705 (ICTRP)
Risultati dello studio
Riepilogo dei risultati
non disponibile
Link ai risultati nel registro primario
non disponibile