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A Randomized, Double-Blind, Two-Period Crossover Study to Assess the Efficacy And Safety of the Ampakine® Compound, CX717, versus Placebo in Adults with Attention-Deficit Hyperactivity Disorder
This study examined the clinical efficacy, tolerability and safety of CX717 in the treatment of adults with ADHD. The study was a double-blind, 2-period crossover study that compared 2 different doses of CX717 with placebo. Subjects were randomized to 1 of 4 different treatment sequences: placebo - low dose; low dose - placebo; placebo - high dose; or high dose - placebo. Each treatment period was 3 weeks with a 2-week washout between treatment periods. The doses chosen were 200 mg b.i.d. and 800 mg b.i.d.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sequence 1 PL | Experimental | Eligible subjects were randomized to Sequence 1 PL in which they received placebo (P) followed by crossover to CX717 200 mg low dose (L) of active treatment |
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| Sequence 2 PH | Experimental | Eligible subjects were randomized to Sequence 2 PH in which they received placebo (P) followed by crossover to CX717 800 mg High dose (H) of active treatment |
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| Sequence 3 LP | Experimental | Eligible subjects were randomized to Sequence 3 LP in which they received CX717 200 mg Low dose (L) of active treatment followed by crossover to placebo (P) |
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| Sequence 4 HP | Experimental | Eligible subjects were randomized to Sequence 2 PH in which they received CX717 800 mg High dose (H) of active treatment followed by crossover to placebo (P) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CX717 200 mg | Drug | CX717 200 mg capsules BID |
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| Measure | Description | Time Frame |
|---|---|---|
| ADHD-RS | Attention-Deficit Hyperactivity Disorder Rating Scale (ADHD-RS) with Prompts The ADHD-RS is an 18-item scale that assesses the severity ADHD symptoms based on the symptom list in the DSM-IV. It is administered by a qualified health care professional. Each item is rated 0 - 3 (0=not present and 3=severe). Thus the scale has a range from 0 to 54. | 3 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| ADHD-RS subscales | Attention Deficit Hyperactivity Disorder Rating Subscales: hyperactivity consisting of items 1-4, 8-10, 17-18, and inattentiveness consisting of items 5-7 and 11-16. | 3 Weeks |
| CGI-I |
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Inclusion Criteria:
Subject had ADHD as established by the Adult ADHD Clinical Diagnostic Scale (ACDS) Version 1.2
Patients must have at least moderately severe ADHD symptoms:
Subject was male
Subject was 18 - 50 years old, inclusive
Subject could read well enough to understand the informed consent form and other patient materials.
Exclusion Criteria:
Subject had a DSM-IV diagnosis of ADHD not otherwise specified
Subject had a current or lifetime history of bipolar disorder or any psychotic disorder as established by the Structured Clinical Interview for DSM-IV (SCID) (12)
Subject had a current history of major depression, substance abuse or dependence, generalized anxiety disorder, obsessive compulsive disorder, panic disorder, or posttraumatic stress disorder as established by SCID
Subject had a history of epilepsy, seizures, syncope, unexplained blackout spell(s), head trauma with loss of consciousness, or febrile seizures
Subject had a currently active medical condition (other than ADHD) that in the opinion of the Investigator could interfere with the ability of subject to participate in the study
Subject had a history of development delay in milestones
By history, the subject had an IQ less than 80
In the opinion of the Investigator, the subject had not derived significant therapeutic benefit from 2 or more appropriately dosed ADHD therapies
Subject was currently taking medication specifically for treatment of ADHD symptoms (e.g., stimulants, atomoxetine, tricyclic antidepressants, or bupropion).
NOTE: subjects were off of stimulants for 2 weeks and off non-stimulant ADHD therapies for 4 weeks prior to the Period 1 Baseline Visit. Subject did not have evidence of a discontinuation or withdrawal reaction.
Subject was currently taking an anti-depressant prescription medication (e.g., paroxetine, sertraline, venlafaxine, etc.) or St. John's Wort
Subject was currently taking an anti-convulsant medication (e.g., phenytoin, carbamazepine, lamotrigine, valproic acid, etc.) or anti-psychotic medication
Subject had a clinically relevant abnormality on Screening evaluation including physical examination, vital signs, ECG, or laboratory tests
Subject was currently taking on a chronic basis any medication known to be primarily metabolized by a route other than the cytochrome P450 system
Subject was unwilling to refrain from taking medications that may have interfered with the assessment of cognitive function. Examples included benzodiazepines, sedating anti-histamines, zolpidem, and zaleplon. Herbal preparations with effects on the central nervous system (e.g., St. John's Wort, melatonin) were prohibited. These medications and herbal preparations were also prohibited throughout the study.
Subject was unwilling to refrain from taking more than 1 unit of alcohol within 24 hours of the clinic visits
Subject had a Body Mass Index (BMI) of less than 18 or greater than 35. No waivers were allowed.
Subject reported passive or active suicidal ideation or intent
Subject was concurrently participating in another clinical research study or investigational drug trial or had participated within the past 1 month
Subject was at high risk of non-compliance in the Investigator's opinion
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| Name | Affiliation | Role |
|---|---|---|
| Len Adler, MD | NYU School of Medicine | Principal Investigator |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| C542518 | CX717 |
| D003276 | Contraceptives, Oral |
| ID | Term |
|---|---|
| D003271 | Contraceptive Agents, Female |
| D003270 | Contraceptive Agents |
| D012102 | Reproductive Control Agents |
| D045505 | Physiological Effects of Drugs |
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A Randomized, Double-Blind, Two-Period Crossover Study
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200 mg of drug product or placebo in matching size 0 capsules
| CX717 800 mg | Drug | CX717 4 X 200 mg capsules BID |
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| Placebo | Drug | Placebo 200 mg or 800 mg capsules BID |
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Clinical Global Impression of Improvement
| 3 Weeks |
| HAM-A | Hamilton Rating Scale of Anxiety | 3 Weeks |
| HAM-D | Hamilton Rating Scale of Depression | 3 Weeks |
| PSQI | Pittsburgh Sleep Quality Index | 3 Weeks |
| ESS | Eppworth Sleepiness Scale | 3 Weeks |
| ADHD-SRS | Attention Deficit Hyperactivity Disorder Self Rating Scale | 3 Weeks |
| SCWT | Stroop Color and Word Test | 3 Weeks |
| CTMT | Comprehensive Trail Making Test | 3 Weeks |
| CPT | Continuous Performance Task | 3 Weeks |
| FBDS | Forward and Backward Digit Span | 3 Weeks |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D045506 | Therapeutic Uses |