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Safety and Efficacy of Divalproex and Quetiapine in Elderly Alzheimer's Dementia Patients

Primary Purpose

Alzheimer's Disease, Dementia, Behavioral Symptoms

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Divalproex ER
Quetiapine
Sponsored by
University of Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Alzheimer's Disease

Eligibility Criteria

55 Years - 85 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Patients, men and women =/> 55 years of age.
  2. Inpatient / Outpatients with diagnosis of Moderate to Severe probable Alzheimer's dementia as determined by the Structured Clinical Interview for DSM-IV.
  3. Patients with a Mini Mental Status Examination scores between 3-15 at screening.
  4. Patients and Care Giver/ Legal representative or Guardian who are able to comprehend and satisfactorily comply with protocol requirements.
  5. Patient, Care Giver/ Legal representative or Guardian who signed the written informed consent given prior to entering any study procedure.
  6. Patients who have been at least three month ongoing stable dose of cholinesterase enzyme inhibitors or memantine.

Exclusion Criteria:

  1. Patients with a concurrent DSM-IV Axis I diagnosis in any of the following categories:

    1.1. Delirium, Amnestic and other Cognitive disorders 1.2. Lifetime Schizophrenia and other Psychotic Disorders 1.3. Lifetime Bipolar I Disorder 1.4. Bipolar 11 Disorder with an episode of hypomania within the last year 1.5. Alcohol or Substance Dependence or Abuse (excluding nicotine) in one month prior to the Screening Visit

  2. Patients with a history of intolerance or hypersensitivity to Divalproex ER & Quetiapine.
  3. Patients who have a history of seizures.
  4. Patients who based on history or mental status examination have a significant risk of committing suicide.
  5. Patients who are homicidal or violent and who are in the Investigator's opinion in significant imminent risk of hurting others.
  6. Patients who have been treated with depot-neuroleptic within 3 months prior to the Baseline Visit.
  7. Patients with a positive urine drug screen, unless proven to be prescribed for a short-term course of treatment. In these situations a urine drug screen must be repeated at least 7 days after the last dose of the prescription medication containing narcotics.
  8. Patients who have participated in any clinical trial within one month prior to the Screening Visit, or in a clinical trial involving a psychotropic medication within the 3 months prior to the Screening Visit.
  9. Patients who have a medical condition that, in the Investigator's opinion, would expose them to an increased risk of a significant adverse event or interfere with assessments of safety and efficacy during the course of the trial.
  10. Patients with any current malignancy, or any clinically significant hematological, endocrine, cardiovascular, renal, hepatic, gastrointestinal or neurological disease (including any form of epilepsy). If there is a history of such disease but the condition has been stable for at least the past year and is judged by the investigator not to interfere with the patient's participation in the study, the patient may be included.
  11. Patients with systolic blood pressure greater than 180 mm Hg or less than 90 mm Hg or diastolic blood pressure greater than 105 mm Hg or less than 50 mm Hg at the Screening visit.
  12. Patients who test positive for Hepatitis B surface antigen or Hepatitis C antibody.
  13. Patients whose laboratory values at the Screening visit will be 1.5 times greater than ULN.
  14. Patients requiring concomitant treatment with any psychotropic drug (except zolpidem for sleep no more than 3x/week prn).
  15. Patients who require concomitant therapy with any prohibited prescription.
  16. Patients who are unable to speak, read, and understand English or are judged by the investigator to be unable or unlikely to follow the study protocol and complete all scheduled visits.

Sites / Locations

  • Cincinnati VA Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

1

2

Arm Description

Quetiapine

Divalproex ER

Outcomes

Primary Outcome Measures

The change from the Baseline to the End of the Study/Early Termination visit in the CMAI & Quality of life scale scores.

Secondary Outcome Measures

Full Information

First Posted
September 11, 2006
Last Updated
May 26, 2015
Sponsor
University of Cincinnati
Collaborators
Abbott
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1. Study Identification

Unique Protocol Identification Number
NCT00375557
Brief Title
Safety and Efficacy of Divalproex and Quetiapine in Elderly Alzheimer's Dementia Patients
Official Title
An Open Label, Randomized, Flexible Dose, 6-week Clinical Trial of the Safety and Efficacy of Divalproex ER vs Quetiapine in the Treatment of Behavioral Symptoms in the Elderly With Moderate to Severe Alzheimer's Dementia
Study Type
Interventional

2. Study Status

Record Verification Date
May 2015
Overall Recruitment Status
Withdrawn
Study Start Date
October 2006 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
September 2007 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Cincinnati
Collaborators
Abbott

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary aim is to determine whether Divalproex ER or one of the atypical antipsychotics is more effective improving dementia related behavioral symptoms in patients with dementia, and evaluate the impact of such improvements on other clinical domains, such as quality of life, functional status.
Detailed Description
This clinical trial will be open label, flexible dose study of Divalproex ER vs Quetiapine for 6 weeks. Patients will be randomized to Divalproex ER vs Quetiapine outpatient / inpatient. The schedule of visits will include a screening, a baseline and 3 treatment visits / assessment. The End of Study/Early Termination visit will conclude the Trial. The safety follow-up visit will be scheduled only for the patients with unresolved Adverse Events detected prior or at the End of Study/Early Termination visit.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Alzheimer's Disease, Dementia, Behavioral Symptoms

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
1
Arm Type
Active Comparator
Arm Description
Quetiapine
Arm Title
2
Arm Type
Active Comparator
Arm Description
Divalproex ER
Intervention Type
Drug
Intervention Name(s)
Divalproex ER
Other Intervention Name(s)
Depakote ER
Intervention Description
Divalproex ER will be initiated on 250 mg/day, dosed once daily. The daily dose of Divalproex ER will be titrated up 250 mg each day based on patients' response and tolerability, not to exceed a maximum of 2000 mg/day.
Intervention Type
Drug
Intervention Name(s)
Quetiapine
Other Intervention Name(s)
Seroquel
Intervention Description
Quetiapine will be initiated in 25 mg/day, with a variable dosing frequency (QD-TID). The daily dose of Quetiapine will be titrated up by 25-50 mg each day based on patients' response and tolerability, not to exceed a maximum of 750 mg/day.
Primary Outcome Measure Information:
Title
The change from the Baseline to the End of the Study/Early Termination visit in the CMAI & Quality of life scale scores.
Time Frame
6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
55 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patients, men and women =/> 55 years of age. Inpatient / Outpatients with diagnosis of Moderate to Severe probable Alzheimer's dementia as determined by the Structured Clinical Interview for DSM-IV. Patients with a Mini Mental Status Examination scores between 3-15 at screening. Patients and Care Giver/ Legal representative or Guardian who are able to comprehend and satisfactorily comply with protocol requirements. Patient, Care Giver/ Legal representative or Guardian who signed the written informed consent given prior to entering any study procedure. Patients who have been at least three month ongoing stable dose of cholinesterase enzyme inhibitors or memantine. Exclusion Criteria: Patients with a concurrent DSM-IV Axis I diagnosis in any of the following categories: 1.1. Delirium, Amnestic and other Cognitive disorders 1.2. Lifetime Schizophrenia and other Psychotic Disorders 1.3. Lifetime Bipolar I Disorder 1.4. Bipolar 11 Disorder with an episode of hypomania within the last year 1.5. Alcohol or Substance Dependence or Abuse (excluding nicotine) in one month prior to the Screening Visit Patients with a history of intolerance or hypersensitivity to Divalproex ER & Quetiapine. Patients who have a history of seizures. Patients who based on history or mental status examination have a significant risk of committing suicide. Patients who are homicidal or violent and who are in the Investigator's opinion in significant imminent risk of hurting others. Patients who have been treated with depot-neuroleptic within 3 months prior to the Baseline Visit. Patients with a positive urine drug screen, unless proven to be prescribed for a short-term course of treatment. In these situations a urine drug screen must be repeated at least 7 days after the last dose of the prescription medication containing narcotics. Patients who have participated in any clinical trial within one month prior to the Screening Visit, or in a clinical trial involving a psychotropic medication within the 3 months prior to the Screening Visit. Patients who have a medical condition that, in the Investigator's opinion, would expose them to an increased risk of a significant adverse event or interfere with assessments of safety and efficacy during the course of the trial. Patients with any current malignancy, or any clinically significant hematological, endocrine, cardiovascular, renal, hepatic, gastrointestinal or neurological disease (including any form of epilepsy). If there is a history of such disease but the condition has been stable for at least the past year and is judged by the investigator not to interfere with the patient's participation in the study, the patient may be included. Patients with systolic blood pressure greater than 180 mm Hg or less than 90 mm Hg or diastolic blood pressure greater than 105 mm Hg or less than 50 mm Hg at the Screening visit. Patients who test positive for Hepatitis B surface antigen or Hepatitis C antibody. Patients whose laboratory values at the Screening visit will be 1.5 times greater than ULN. Patients requiring concomitant treatment with any psychotropic drug (except zolpidem for sleep no more than 3x/week prn). Patients who require concomitant therapy with any prohibited prescription. Patients who are unable to speak, read, and understand English or are judged by the investigator to be unable or unlikely to follow the study protocol and complete all scheduled visits.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Muhammad Aslam, MD
Organizational Affiliation
University of Cincinnati/ VA Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cincinnati VA Hospital
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45220
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
16375658
Citation
Profenno LA, Jakimovich L, Holt CJ, Porsteinsson A, Tariot PN. A randomized, double-blind, placebo-controlled pilot trial of safety and tolerability of two doses of divalproex sodium in outpatients with probable Alzheimer's disease. Curr Alzheimer Res. 2005 Dec;2(5):553-8. doi: 10.2174/156720505774932205.
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Safety and Efficacy of Divalproex and Quetiapine in Elderly Alzheimer's Dementia Patients

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