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Efficacy of Galantamine to Treat Schizophrenia

Primary Purpose

Schizophrenia, Psychotic Disorder

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
galantamine
Sponsored by
Seattle Institute for Biomedical and Clinical Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring schizophrenia, galantamine, cholinesterase inhibitors, quality of life, cognition

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Age 18-60 Able to provide informed, written consent Treatment for schizophrenia or schizoaffective disorder for 5 or more years Diagnosis of schizophrenia or schizoaffective disorder Psychiatrically stable as evidenced by no hospitalizations and no changes in psychiatric medications (with the exception of dosage adjustments and the prescription of adjunctive treatments for sleep disturbance or anxiety) within the prior 3 months, and as confirmed by clinical interview during the screening phase Total score > 60 baseline on The Positive and Negative Syndrome Scale (PANSS) Score > 3 on at least one of the five subscales of the SANS Non-Kraepelinian schizophrenia, as defined by the ability to independently provide for at least one domain of basic needs Females must be of non-child bearing potential or on appropriate contraceptive and not breast-feeding Females must have a negative serum beta HCG at screening Clinical laboratory values within normal limits, as defined in study protocol, or abnormalities considered not clinically significant by the investigator Exclusion Criteria: Kraepelinian schizophrenia, as defined by dependency on others for the provision of all basic needs (including shopping, food preparation, household chores, and transportation); DSM-IV criteria for substance dependence (excluding nicotine and caffeine), as determined by SCID and chart review, during the 90 days prior to screening; Patients judged by the investigator as being at significant risk of suicide, violent behavior, or homicide; Concurrent participation or participation within the prior 30 days in any study involving investigational medications; Females who are pregnant or lactating; Neurodegenerative disorders such as Alzheimer's disease and other dementias, Parkinson's disease, Pick's disease, and Huntington's chorea; A history of significant cerebrovascular event yielding a physical or neurological deficit likely to confound the assessment of the subject's functioning; A history of significant head trauma, defined as head trauma resulting in neurological or cognitive sequelae; A known personal history of seizure disorder; A known sensitivity to cholinesterase inhibitors, choline agonists, or similar agents; Patients who are known to be HIV positive; Evidence of clinically significant, active gastrointestinal, hepatic, pulmonary, endocrine, renal, or cardiovascular system disease; Active or clinically significant conditions affecting absorption, distribution or metabolism of the study medication (e.g. inflammatory bowel disease or gastric or duodenal ulcers); Clinically significant urinary outflow obstruction; Patients with untreated thyroid disease; Patients with Type I or Type II diabetes controlled by medication or diet who do not have a HbA1c of < 8.5%; Patients with known significant cardiac history such as myocardial infarction or abnormal cardiac catheterization within the last 12 months. Unstable angina: angina or coronary artery disease requiring a change in medications within the 3 months prior to screening; Decompensated congestive heart failure; Severe mitral or aortic valvular disease; Atrial fibrillation; Greater than first degree atrioventricular block; QTc prolongation at screening; Bradycardia <50 beats/min; Current treatment with clozapine, olanzapine, chlorpromazine, or thioridazine; Use of potent cytochrome P450 inhibitors or inducers within 14 days before the Baseline Visit or during treatment, as listed in Appendix B of protocol; Current use of potent anticholinergic medication, as listed in Appendix B; Current use of any disallowed concomitant medication, as listed in Appendix B; and Any clinical finding that in the opinion of the investigator could potentially be negatively affected by study participation or that could potentially affect study participation is criterion for exclusion from the study.

Sites / Locations

  • VA Puget Sound Health Care System, American Lake Division

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Intervention group

Arm Description

All subjects enrolled in study are in the intervention group.

Outcomes

Primary Outcome Measures

score on a measure of quality of life
score on a measure of independent living skills

Secondary Outcome Measures

score on a measure of psychopathology
score on a measure of negative symptoms
score on a neurocognitive battery

Full Information

First Posted
September 30, 2005
Last Updated
July 30, 2008
Sponsor
Seattle Institute for Biomedical and Clinical Research
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1. Study Identification

Unique Protocol Identification Number
NCT00232349
Brief Title
Efficacy of Galantamine to Treat Schizophrenia
Official Title
An Open-Label Trial of Adjunctive Galantamine Maintenance Therapy to Treat Functional Impairments in Chronic Outpatients With Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
July 2008
Overall Recruitment Status
Terminated
Why Stopped
Study terminated due to no apparent benefit.
Study Start Date
February 2005 (undefined)
Primary Completion Date
June 2007 (Actual)
Study Completion Date
June 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Seattle Institute for Biomedical and Clinical Research

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study was to determine if treatment with adjunctive galantamine is effective in the reduction of functional impairments in patients with schizophrenia and schizoaffective disorder. It was hypothesized that adjunctive galantamine would yield clinically significant improvements from baseline to end of study on a measure of quality of life and a measure of independent living skills.
Detailed Description
A majority of patients with schizophrenia or schizoaffective disorder experience impairments in social relations and employment. Many patients experience impairments in their ability to live independently, requiring assistance in such activities as money management, shopping, food preparation and hygiene. These impairments in functioning have been shown to be related to cognitive deficits associated with the disease. Galantamine is a medication that has been approved by the FDA for the treatment of mild to moderate Alzheimer's disease. Both animal and human models have shown that galantamine can enhance learning and memory. Case reports and preliminary research have suggested that galantamine is an effective adjunctive treatment for schizophrenia, improving both cognition and negative symptoms. Improvements in functioning require that gains in cognition be maintained long enough to allow for the acquisition and application of new skills and behaviors. Thus, this nine month, open label study assessed the efficacy of galantamine, dosed at 4-12 mg/twice a day, for the treatment of functional impairments in individuals, ages 18-60, with schizophrenia and schizoaffective disorder. The primary outcome measures were changes from baseline to end of study in scores on the Independent Living Scale (ILS) and the Quality of Life Scale (QLS). Secondary outcome measures included assessments of symptoms, cognition, side effects, and movement disorders. Twenty-one subjects signed informed consent and fourteen subjects were initiated on medication. Six subjects completed the study. As per a priori plan, those subjects (n = 8) who were treated with study medication for at least four months were included in the analyses of treatment outcomes. Our findings regarding the efficacy of galantamine for functional outcomes, including activities of daily living and quality of life, did not support our hypothesis that long-term treatment with galantamine would yield improvements in these domains in patients with schizophrenia spectrum disorders. In fact, in the current study, we did not observe any anticipated improvements in cognition. In addition, we did not observe any anticipated improvements in symptoms, specifically negative symptoms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Psychotic Disorder
Keywords
schizophrenia, galantamine, cholinesterase inhibitors, quality of life, cognition

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Intervention group
Arm Type
Experimental
Arm Description
All subjects enrolled in study are in the intervention group.
Intervention Type
Drug
Intervention Name(s)
galantamine
Other Intervention Name(s)
Razadyne, Reminyl
Intervention Description
open label galantamine, dosed at 4-12 mg/b.i.d., with a target dose of 12 mg/b.i.d.
Primary Outcome Measure Information:
Title
score on a measure of quality of life
Time Frame
after 9 months treatment
Title
score on a measure of independent living skills
Time Frame
after 9 months treatment
Secondary Outcome Measure Information:
Title
score on a measure of psychopathology
Time Frame
after 9 months treatment
Title
score on a measure of negative symptoms
Time Frame
after 9 months treatment
Title
score on a neurocognitive battery
Time Frame
after 9 months treatment

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 18-60 Able to provide informed, written consent Treatment for schizophrenia or schizoaffective disorder for 5 or more years Diagnosis of schizophrenia or schizoaffective disorder Psychiatrically stable as evidenced by no hospitalizations and no changes in psychiatric medications (with the exception of dosage adjustments and the prescription of adjunctive treatments for sleep disturbance or anxiety) within the prior 3 months, and as confirmed by clinical interview during the screening phase Total score > 60 baseline on The Positive and Negative Syndrome Scale (PANSS) Score > 3 on at least one of the five subscales of the SANS Non-Kraepelinian schizophrenia, as defined by the ability to independently provide for at least one domain of basic needs Females must be of non-child bearing potential or on appropriate contraceptive and not breast-feeding Females must have a negative serum beta HCG at screening Clinical laboratory values within normal limits, as defined in study protocol, or abnormalities considered not clinically significant by the investigator Exclusion Criteria: Kraepelinian schizophrenia, as defined by dependency on others for the provision of all basic needs (including shopping, food preparation, household chores, and transportation); DSM-IV criteria for substance dependence (excluding nicotine and caffeine), as determined by SCID and chart review, during the 90 days prior to screening; Patients judged by the investigator as being at significant risk of suicide, violent behavior, or homicide; Concurrent participation or participation within the prior 30 days in any study involving investigational medications; Females who are pregnant or lactating; Neurodegenerative disorders such as Alzheimer's disease and other dementias, Parkinson's disease, Pick's disease, and Huntington's chorea; A history of significant cerebrovascular event yielding a physical or neurological deficit likely to confound the assessment of the subject's functioning; A history of significant head trauma, defined as head trauma resulting in neurological or cognitive sequelae; A known personal history of seizure disorder; A known sensitivity to cholinesterase inhibitors, choline agonists, or similar agents; Patients who are known to be HIV positive; Evidence of clinically significant, active gastrointestinal, hepatic, pulmonary, endocrine, renal, or cardiovascular system disease; Active or clinically significant conditions affecting absorption, distribution or metabolism of the study medication (e.g. inflammatory bowel disease or gastric or duodenal ulcers); Clinically significant urinary outflow obstruction; Patients with untreated thyroid disease; Patients with Type I or Type II diabetes controlled by medication or diet who do not have a HbA1c of < 8.5%; Patients with known significant cardiac history such as myocardial infarction or abnormal cardiac catheterization within the last 12 months. Unstable angina: angina or coronary artery disease requiring a change in medications within the 3 months prior to screening; Decompensated congestive heart failure; Severe mitral or aortic valvular disease; Atrial fibrillation; Greater than first degree atrioventricular block; QTc prolongation at screening; Bradycardia <50 beats/min; Current treatment with clozapine, olanzapine, chlorpromazine, or thioridazine; Use of potent cytochrome P450 inhibitors or inducers within 14 days before the Baseline Visit or during treatment, as listed in Appendix B of protocol; Current use of potent anticholinergic medication, as listed in Appendix B; Current use of any disallowed concomitant medication, as listed in Appendix B; and Any clinical finding that in the opinion of the investigator could potentially be negatively affected by study participation or that could potentially affect study participation is criterion for exclusion from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Andre Tapp, M.D.
Organizational Affiliation
VA Puget Sound Health Care System, Tacoma and Seattle, WA and University of Washington, Department of Psychiatry and Behavioral Sciences, Seattle, WA
Official's Role
Principal Investigator
Facility Information:
Facility Name
VA Puget Sound Health Care System, American Lake Division
City
Tacoma
State/Province
Washington
ZIP/Postal Code
98493
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
12091212
Citation
Allen TB, McEvoy JP. Galantamine for treatment-resistant schizophrenia. Am J Psychiatry. 2002 Jul;159(7):1244-5. doi: 10.1176/appi.ajp.159.7.1244. No abstract available.
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Efficacy of Galantamine to Treat Schizophrenia

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