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Divalproex Sodium ER in Adult Autism

Primary Purpose

Autism

Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Divalproex Sodium ER
Sponsored by
Montefiore Medical Center
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Autism focused on measuring autism, divalproex sodium ER, aggression, irritability

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Meet DSM-IV, ADI, or ADOS criteria for autism spectrum disorder. Age 18-65. Be seen as outpatients Demonstrate capacity to provide authorized informed consent or provide consent for participation by an approved surrogate on the autistic individual's behalf Sexually active females of childbearing potential must use an acceptable method of birth control and have a negative serum pregnancy test prior to entry into the study. Score at least 4 (moderately ill) on the Clinical Global Impression-Severity Scale for Autistic Disorder (CGI-AD). Subject meets the following criteria at pre-study diagnostic assessment and baseline assessment: OAS-M 6 (raw scores). Subjects on a stable dose of their current psychotropic medication for at least 3 months before entering the study, with the understanding that they must remain on a stable dose throughout the trial. If a subject chooses to taper off their current medications, they will be closely monitored by the study psychiatrist and must be medication free for 2 weeks prior to beginning the study. Additionally, if a subject is currently taking a medication with a known drug interaction with Divalproex Sodium, he/she will be tapered off of that medication under the supervision of the study psychiatrist before undergoing treatment. Exclusion Criteria: Subjects who are pregnant or nursing mothers. Sexually active women of childbearing potential who are not using adequate birth control measures. Subjects with active or unstable epilepsy. Subjects with any of the following past or present mental disorders: schizophrenia, schizoaffective disorder, bipolar disorder, or organic mental disorders. Subjects who are a serious suicidal risk. Subjects with clinically significant or unstable medical illness that would contraindicate participation in the study, including hematopoietic or cardiovascular disease, pancreatitis, liver toxicity, and polycystic ovary syndrome. Subjects reporting history of encephalitis, phenylketonuria, tuberous schelrosis, fragile X syndrome, anoxia during birth, pica, neurofibromatosis, hypomelanosis of Ito, hypothyroidism, Duchenne muscular dystrophy, and maternal rubella. Patients with history of the following: gastrointestinal, liver, or kidney, or other known conditions which will presently interfere presently with the absorption, distribution, metabolism, or excretion of drugs. cerebrovascular disease or brain trauma clinically significant unstable endocrine disorder, such as hypo- or hyperthyroidism recent history or presence of any form of malignancy Subjects with an unstable history of seizures cannot participate in the study. However, subjects who have been seizure-free for at least 6 months on a stable dose of anticonvulsant medication other than divalproex sodium or related formulations (e.g., depakene) may participate, along with non-medicated subjects with a history of seizures who have been seizure-free for at least 6 months. Subjects with abnormal EEG but no clinical seizures are also eligible. Treatment within the previous 30 days with any drug known to a well-defined potential for toxicity to a major organ Subjects with clinically significant abnormalities in laboratory tests or physical exam. Subjects with a history of hypersensitivity or severe side effects associated with the use of divalproex sodium, or other an ineffective prior therapeutic trial of divalproex sodium (serum levels within range of 50-100 ug/ml for 6 weeks). Subjects who are currently taking a medication with a known drug interaction with Divalproex Sodium (betamipron, chaparral, cholestyramine, clarithromycin, comfrey, ethosuximide, evening primrose, felbamate, fosphenytoin, germander, ginkgo, jin bu huan, kava, mefloquine, panipenem, pennyroyal, primidone, rifampin, rifapentine, and zidovudine) and refuse to taper off of that medication. Subjects who are already being treated with Divalproex Sodium. Subjects with any organic or systemic disease or patients who require a therapeutic intervention, not otherwise specified, which would confound the evaluation of the safety of the study medication. Subjects who reside in a remote geographical area who do not have regular access to transportation to the clinical facility.

Sites / Locations

  • Mount Sinai School of Medicine

Outcomes

Primary Outcome Measures

the Clinical Global Improvement and Severity scales (CGI-I and CGI-S)
Overt Aggression Scale-Modified (OAS M)
Affective Lability Scale (ALS).

Secondary Outcome Measures

Global Assessment of Functioning Scale (GAF)
Aggression Questionnaire (AQ)
the Hamilton Depression (Ham-D) Scale
Yale Brown Obsessive Compulsion Scale (YBOCS)
Compulsion sub-scale
Aberrant Behavior Checklist (ABC)
Barratt Impulsiveness Scale
Version11 (BIS-11).

Full Information

First Posted
September 13, 2005
Last Updated
May 29, 2018
Sponsor
Montefiore Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT00211796
Brief Title
Divalproex Sodium ER in Adult Autism
Official Title
Divalproex Sodium ER in Adult Autism
Study Type
Interventional

2. Study Status

Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
April 2005 (undefined)
Primary Completion Date
April 2007 (Actual)
Study Completion Date
April 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Montefiore Medical Center

4. Oversight

5. Study Description

Brief Summary
12-week open label treatment trial of divalproex sodium extended release (Depakote ER) in 10 patients with a diagnosis of autism. Our objective is to determine how well these patients can tolerate the prescribed doses and what added benefits can be attributed to divalproex sodium ER.
Detailed Description
Based on positive research with divalproex in children/adolescents with autism, we would like to extend this research to autistic adults with high levels of aggression, irritability, affective instability, or agitation. We aim to have 10 adult autistic patients enrolled in our study of the treatment of aggression/irritability with divalproex sodium ER. This will be an open treatment for adult patients to determine if the tolerability of divalproex sodium is better with the extended release. We propose this open label design because previous double-blinded studies of divalproex sodium were only done in children, not adults. These results will serve as pilot data for a future blinded study for autistic adults with the extended release formulation. This naturalistic design will allow for prior stable (3 months) use of concomitant medications. Our objective is to determine how well these patients can tolerate the prescribed doses and what added benefits can be attributed to divalproex sodium ER.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autism
Keywords
autism, divalproex sodium ER, aggression, irritability

7. Study Design

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

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Divalproex Sodium ER
Primary Outcome Measure Information:
Title
the Clinical Global Improvement and Severity scales (CGI-I and CGI-S)
Title
Overt Aggression Scale-Modified (OAS M)
Title
Affective Lability Scale (ALS).
Secondary Outcome Measure Information:
Title
Global Assessment of Functioning Scale (GAF)
Title
Aggression Questionnaire (AQ)
Title
the Hamilton Depression (Ham-D) Scale
Title
Yale Brown Obsessive Compulsion Scale (YBOCS)
Title
Compulsion sub-scale
Title
Aberrant Behavior Checklist (ABC)
Title
Barratt Impulsiveness Scale
Title
Version11 (BIS-11).

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Meet DSM-IV, ADI, or ADOS criteria for autism spectrum disorder. Age 18-65. Be seen as outpatients Demonstrate capacity to provide authorized informed consent or provide consent for participation by an approved surrogate on the autistic individual's behalf Sexually active females of childbearing potential must use an acceptable method of birth control and have a negative serum pregnancy test prior to entry into the study. Score at least 4 (moderately ill) on the Clinical Global Impression-Severity Scale for Autistic Disorder (CGI-AD). Subject meets the following criteria at pre-study diagnostic assessment and baseline assessment: OAS-M 6 (raw scores). Subjects on a stable dose of their current psychotropic medication for at least 3 months before entering the study, with the understanding that they must remain on a stable dose throughout the trial. If a subject chooses to taper off their current medications, they will be closely monitored by the study psychiatrist and must be medication free for 2 weeks prior to beginning the study. Additionally, if a subject is currently taking a medication with a known drug interaction with Divalproex Sodium, he/she will be tapered off of that medication under the supervision of the study psychiatrist before undergoing treatment. Exclusion Criteria: Subjects who are pregnant or nursing mothers. Sexually active women of childbearing potential who are not using adequate birth control measures. Subjects with active or unstable epilepsy. Subjects with any of the following past or present mental disorders: schizophrenia, schizoaffective disorder, bipolar disorder, or organic mental disorders. Subjects who are a serious suicidal risk. Subjects with clinically significant or unstable medical illness that would contraindicate participation in the study, including hematopoietic or cardiovascular disease, pancreatitis, liver toxicity, and polycystic ovary syndrome. Subjects reporting history of encephalitis, phenylketonuria, tuberous schelrosis, fragile X syndrome, anoxia during birth, pica, neurofibromatosis, hypomelanosis of Ito, hypothyroidism, Duchenne muscular dystrophy, and maternal rubella. Patients with history of the following: gastrointestinal, liver, or kidney, or other known conditions which will presently interfere presently with the absorption, distribution, metabolism, or excretion of drugs. cerebrovascular disease or brain trauma clinically significant unstable endocrine disorder, such as hypo- or hyperthyroidism recent history or presence of any form of malignancy Subjects with an unstable history of seizures cannot participate in the study. However, subjects who have been seizure-free for at least 6 months on a stable dose of anticonvulsant medication other than divalproex sodium or related formulations (e.g., depakene) may participate, along with non-medicated subjects with a history of seizures who have been seizure-free for at least 6 months. Subjects with abnormal EEG but no clinical seizures are also eligible. Treatment within the previous 30 days with any drug known to a well-defined potential for toxicity to a major organ Subjects with clinically significant abnormalities in laboratory tests or physical exam. Subjects with a history of hypersensitivity or severe side effects associated with the use of divalproex sodium, or other an ineffective prior therapeutic trial of divalproex sodium (serum levels within range of 50-100 ug/ml for 6 weeks). Subjects who are currently taking a medication with a known drug interaction with Divalproex Sodium (betamipron, chaparral, cholestyramine, clarithromycin, comfrey, ethosuximide, evening primrose, felbamate, fosphenytoin, germander, ginkgo, jin bu huan, kava, mefloquine, panipenem, pennyroyal, primidone, rifampin, rifapentine, and zidovudine) and refuse to taper off of that medication. Subjects who are already being treated with Divalproex Sodium. Subjects with any organic or systemic disease or patients who require a therapeutic intervention, not otherwise specified, which would confound the evaluation of the safety of the study medication. Subjects who reside in a remote geographical area who do not have regular access to transportation to the clinical facility.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric Hollander, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mount Sinai School of Medicine
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States

12. IPD Sharing Statement

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Divalproex Sodium ER in Adult Autism

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