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Ziprasidone for the Treatment of Mania in Children and Adolescents With Bipolar Disorder

Primary Purpose

Bipolar Disorder, Mania

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
ziprasidone (Geodon)
Sponsored by
Massachusetts General Hospital
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bipolar Disorder focused on measuring bipolar disorder, children, ziprasidone, mania

Eligibility Criteria

6 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Males and females age 6 to 18 years of age Parent or legal representative must have a level of understanding sufficient to communicate intelligently with the investigator and study coordinator, and to cooperate with all tests and examinations required by the protocol. Patients and their legal representative must be considered reliable. Each patient and his/her authorized legal representative must understand the nature of the study. The patient's authorized legal representative must sign an informed consent document. Patient must have a diagnosis of bipolar I or bipolar II disorder and currently displaying an acute manic, hypomanic, or mixed episode (with or without psychotic features) according to the DSM-IV based on clinical assessment and confirmed by structured diagnostic interview (Kidd Schedule of Affective Disorders). Patients must have an initial score on the Y-MRS total score of at least 15. Patient must be able to participate in mandatory blood draws. Patient must be able to swallow pills. Exclusion Criteria: Patients with chronic medical illness, DSM-IV substance dependence within the past 6 months, pregnant or nursing females, and those at serious risk of suicide will be excluded from the study investigator and his/her immediate family; defined as the investigator's spouse, parent, child, grandparent, or grandchild. Serious unstable illness including hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease. Known history of QT prolongation (ie. Congenital long QT syndrome), cardiac arrhythmia, recent myocardial infarction, or heart failure Concurrent medications known to prolong the QT interval including: antiarrhythmics (quinidine), antimicrobials and antimalarials (erythromycin, clarithromycin, ketoconazole, sparfloxacin, moxifloxacin, levofloxacin, gatifloxacin, chloroquine) and antihistamines (diphenhydramine, hydroxyzine). Known hypokalemia or hypomagnesemia Uncorrected hypothyroidism or hyperthyroidism History of severe allergies or multiple adverse drug reactions Non-febrile seizures without a clear and resolved etiology Leukopenia or history of leucopenia without a clear and resolved etiology DSM-IV substance (except nicotine or caffeine) dependence within the past 6 months Judged clinically to be at serious suicidal risk Any other concomitant medication with primarily central nervous system activity other than specified in Concomitant Medication portion of the protocol History of intolerance of Ziprasidone as determined by the principal investigator. Treatment with an irreversible monoamine oxidase inhibitor within 2 weeks prior to visit 2 Current diagnosis of schizophrenia For concomitant stimulant therapy used to treat ADHD, patients must have been on a stable dose of medication for 1 month prior to randomization

Sites / Locations

  • Massachusetts General Hospital
  • Massachusetts General Hospital

Outcomes

Primary Outcome Measures

reduction in symptoms assessed by
Clinical Global Improvement scale (Severity, Improvement and Efficacy Index)
Young Mania Rating Scale

Secondary Outcome Measures

Full Information

First Posted
September 13, 2005
Last Updated
October 21, 2013
Sponsor
Massachusetts General Hospital
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT00181922
Brief Title
Ziprasidone for the Treatment of Mania in Children and Adolescents With Bipolar Disorder
Official Title
Open-Label Study of Ziprasidone for the Treatment of Mania in Children and Adolescents With Bipolar Spectrum Disorder
Study Type
Interventional

2. Study Status

Record Verification Date
October 2013
Overall Recruitment Status
Completed
Study Start Date
March 2002 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
December 2004 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Massachusetts General Hospital
Collaborators
Pfizer

4. Oversight

5. Study Description

Brief Summary
The objective of this study is to compare the safety and effectiveness of Ziprasidone in the treatment of mania in children and adolescents with Bipolar disorder over 8 weeks. This is an exploratory, open-label study, which seeks to determine if there is evidence for efficacy. The results of this study will be used to generate hypotheses for a larger study.
Detailed Description
Initial clinical evidence suggests that atypical neuroleptics may play a unique therapeutic role in the management of symptoms in youth with bipolar disorder. Ziprasidone is classed as an atypical neuroleptic because of its unique pharmacological profile that includes both D2 and 5HT2 antagonistic effects. This combined dopaminergic and serotonergic activity seems to be associated not only with antipsychotic effects but also with mood stabilizing, mood elevating and anti-aggressive effects as well as a lower risk for extrapyramidal symptoms and tardive dyskinesia. Ziprasidone in particular has been found to have a higher 5HT2A to D2 receptor affinity ratio, which suggests that the likelihood of extrapyramidal symptoms and hyperprolactinemia may be further decreased. This makes it an ideal candidate to treat mania in children, but although it is used in clinical practice, adequate data has not been collected on its safety and effectiveness. This study included 1) an 8-week acute period, during which participants were observed during weekly visits, and up to a 10-month extension period, during which participants saw a study clinician on a monthly basis, to document the response rate 2) assessment of the impact of Ziprasidone on functional capacities (quality of life, psychosocial function) and cognition, 3) careful assessment of safety and tolerability.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Bipolar Disorder, Mania
Keywords
bipolar disorder, children, ziprasidone, mania

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
20 (false)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
ziprasidone (Geodon)
Primary Outcome Measure Information:
Title
reduction in symptoms assessed by
Title
Clinical Global Improvement scale (Severity, Improvement and Efficacy Index)
Title
Young Mania Rating Scale

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males and females age 6 to 18 years of age Parent or legal representative must have a level of understanding sufficient to communicate intelligently with the investigator and study coordinator, and to cooperate with all tests and examinations required by the protocol. Patients and their legal representative must be considered reliable. Each patient and his/her authorized legal representative must understand the nature of the study. The patient's authorized legal representative must sign an informed consent document. Patient must have a diagnosis of bipolar I or bipolar II disorder and currently displaying an acute manic, hypomanic, or mixed episode (with or without psychotic features) according to the DSM-IV based on clinical assessment and confirmed by structured diagnostic interview (Kidd Schedule of Affective Disorders). Patients must have an initial score on the Y-MRS total score of at least 15. Patient must be able to participate in mandatory blood draws. Patient must be able to swallow pills. Exclusion Criteria: Patients with chronic medical illness, DSM-IV substance dependence within the past 6 months, pregnant or nursing females, and those at serious risk of suicide will be excluded from the study investigator and his/her immediate family; defined as the investigator's spouse, parent, child, grandparent, or grandchild. Serious unstable illness including hepatic, renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, immunologic, or hematologic disease. Known history of QT prolongation (ie. Congenital long QT syndrome), cardiac arrhythmia, recent myocardial infarction, or heart failure Concurrent medications known to prolong the QT interval including: antiarrhythmics (quinidine), antimicrobials and antimalarials (erythromycin, clarithromycin, ketoconazole, sparfloxacin, moxifloxacin, levofloxacin, gatifloxacin, chloroquine) and antihistamines (diphenhydramine, hydroxyzine). Known hypokalemia or hypomagnesemia Uncorrected hypothyroidism or hyperthyroidism History of severe allergies or multiple adverse drug reactions Non-febrile seizures without a clear and resolved etiology Leukopenia or history of leucopenia without a clear and resolved etiology DSM-IV substance (except nicotine or caffeine) dependence within the past 6 months Judged clinically to be at serious suicidal risk Any other concomitant medication with primarily central nervous system activity other than specified in Concomitant Medication portion of the protocol History of intolerance of Ziprasidone as determined by the principal investigator. Treatment with an irreversible monoamine oxidase inhibitor within 2 weeks prior to visit 2 Current diagnosis of schizophrenia For concomitant stimulant therapy used to treat ADHD, patients must have been on a stable dose of medication for 1 month prior to randomization
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joseph Biederman, MD
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Massachusetts General Hospital
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Massachusetts General Hospital
City
Cambridge
State/Province
Massachusetts
ZIP/Postal Code
02138
Country
United States

12. IPD Sharing Statement

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Ziprasidone for the Treatment of Mania in Children and Adolescents With Bipolar Disorder

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