search
Back to results

Galantamine and Memantine Combination for Cognitive Impairments in Schizophrenia

Primary Purpose

Schizophrenia, Schizoaffective Disorder

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Galantamine ER
Memantine XR
Sponsored by
Sheppard Pratt Health System
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring Schizophrenia, Schizoaffective Disorder, Cognition, Cognitive Impairment, Galantamine, Memantine

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Be male or female aged 18 to 55 years (inclusive).
  • Have a DSM-5 diagnosis of schizophrenia or schizoaffective disorder confirmed by medical records. Duration of illness must be ≥ 1year.
  • Be clinically stable for at least two months (i.e., has no more than a "moderately severe" severity rating on the following BPRS items: hallucination, unusual thought content and conceptual disorganization.
  • Have not had a psychiatric hospitalization in the two months prior to screening.
  • Be taking any 1st generation antipsychotic prescribed in the absence of a concomitant anticholinergic or 2nd generation antipsychotic and minimal extrapyramidal symptoms
  • Have a Simpson-Angus Score (SAS) < 6
  • Be on current medication regimen for at least six weeks before screening at stable dose and frequency for at least 30 days before screening.
  • Be in good general health and expected to complete the clinical study as designed.
  • Subjects of childbearing potential must agree to use two forms of non-hormonal contraception (dual contraception) consistently during the screening and treatment periods of the trial, and for 30 days after the final dose of the study medications.
  • Females of child-bearing potential must have a negative urine pregnancy test at baseline. This may also be done at subsequent visits if subject reports possibility of pregnancy.
  • Have a negative urine drug screen at screening. This may be repeated at the discretion of the primary investigator.
  • Have adequate hearing, vision, and language skills to perform the procedures specified in the protocol.
  • Be capable of providing informed consent and have voluntarily provided informed consent.

Exclusion Criteria:

  • Have an active, clinically significant unstable medical condition with 30 days prior to screening.
  • Have dementia.
  • Are pregnant, breastfeeding, or planning to become pregnant
  • Are taking or thinking about taking oral contraceptives or an injectable contraceptive.
  • Are taking benztropine at a dose greater than 2 mg daily.
  • Have a history of Pervasive Development Disorder.
  • Have a history of significant head injury/trauma (defined by one of more of the following: loss of consciousness for more than one hour; recurring seizures resulting from the head injury; and/or clear cognitive sequelae of the injury requiring cognitive rehabilitation.)
  • Have an allergy to anticholinesterase medications (galantamine, rivastigimine, donepezil) and memantine
  • Have a DSM-5 diagnosis of alcohol and/or substance use disorder (other than caffeine and tobacco) within the last 6 months.
  • Are taking a restricted medication: Amitriptyline, Doxepin, Imipramine, Flexeril, Clozapine, and/or cortisol (any oral, injectable, or topical steroid medication)
  • Have a history of seizures excluding a childhood febrile seizure
  • Have received ECT within the last three months prior to screening.
  • Have participated in a clinical trial of any other psychotropic medication within last two months prior to screening.
  • Have a "severe" or "extremely severe" severity rating on the BPRS items: hallucination or unusual thought content.
  • Have more than a "moderate" severity rating on the BPRS item conceptual disorganization .
  • Are currently taking 3 or more antipsychotic medications.

Sites / Locations

  • Sheppard Pratt Health System

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Galantamine ER, Memantine XR

Arm Description

Week 1, Galantamine ER 8 mg HS & Memantine XR 7 mg HS Week 2, Galantamine ER 16 mg HS & Memantine XR 14 mg HS Weeks 3-6, Galantamine ER 24 mg HS & Memantine XR 21 mg HS

Outcomes

Primary Outcome Measures

Change in Level of Cognition
The primary outcome measure will be the change in level of cognition as measured by the MATRICS Consensus Cognitive Battery (MCCB). In schizophrenia, usual composite scores are 20-39. In healthy controls, usual composite scores are normalized to 40-60. Higher values of composite scores mean better cognition. Test scores are normalized to healthy controls, therefore no min-max range is available. Final scores calculated by MATRICS Consensus Cognitive Battery software. Exact minimum/maximum are not known to provider. Overall composite scores are reported.

Secondary Outcome Measures

Free Tryptophan (TRP)
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate.
Kynurenic Acid (KYNA)
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. MS* AUC is mass spectrometry times area under the curve.
Kynurenine (KYN)
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate.
Picolinic Acid (PIC)
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. MS* AUC is mass spectrometry times area under the curve.
KYN/TRP
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.
KYNA/KYN
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.
PIC/KYN
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.

Full Information

First Posted
September 4, 2014
Last Updated
November 6, 2017
Sponsor
Sheppard Pratt Health System
search

1. Study Identification

Unique Protocol Identification Number
NCT02234752
Brief Title
Galantamine and Memantine Combination for Cognitive Impairments in Schizophrenia
Official Title
A Proof-of Concept Trial of Galantamine and Memantine for Cognitive Impairments in Schizophrenia: Is the Combination Effective?
Study Type
Interventional

2. Study Status

Record Verification Date
October 2016
Overall Recruitment Status
Terminated
Why Stopped
Funding no longer available and PI no longer working at the institution
Study Start Date
September 2014 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sheppard Pratt Health System

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Aim: To examine the efficacy of the combination of galantamine and memantine for the treatment of cognitive deficits in outpatients with schizophrenia. Hypothesis: A combination of galantamine and memantine will improve cognitive impairments in patients with schizophrenia. This is an open-label study to evaluate whether a six week course of galantamine ER and memantine XR is effective in improving the cognitive performance of patients with schizophrenia or schizoaffective disorder. The primary outcome measure will be the change in level of cognition as measured by the MATRICS Consensus Cognitive Battery (MCCB). The results of the MATRICS collaborative project recommended the need for standardized cognitive tests that better distinguish the different facets of cognitive dysfunction in schizophrenia. The MCCB will assess the following seven domains: attention/vigilance, reasoning and problem solving, processing speed, social cognition, verbal learning and memory, visual learning and memory, and working memory. The MCCB will be administered at baseline and at the end of the study. We will report total score and each domain score in the MCCB at baseline and six weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia, Schizoaffective Disorder
Keywords
Schizophrenia, Schizoaffective Disorder, Cognition, Cognitive Impairment, Galantamine, Memantine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Galantamine ER, Memantine XR
Arm Type
Experimental
Arm Description
Week 1, Galantamine ER 8 mg HS & Memantine XR 7 mg HS Week 2, Galantamine ER 16 mg HS & Memantine XR 14 mg HS Weeks 3-6, Galantamine ER 24 mg HS & Memantine XR 21 mg HS
Intervention Type
Drug
Intervention Name(s)
Galantamine ER
Other Intervention Name(s)
Razadyne, Razadyne ER, Formerly known as Reminyl
Intervention Type
Drug
Intervention Name(s)
Memantine XR
Other Intervention Name(s)
Namenda
Primary Outcome Measure Information:
Title
Change in Level of Cognition
Description
The primary outcome measure will be the change in level of cognition as measured by the MATRICS Consensus Cognitive Battery (MCCB). In schizophrenia, usual composite scores are 20-39. In healthy controls, usual composite scores are normalized to 40-60. Higher values of composite scores mean better cognition. Test scores are normalized to healthy controls, therefore no min-max range is available. Final scores calculated by MATRICS Consensus Cognitive Battery software. Exact minimum/maximum are not known to provider. Overall composite scores are reported.
Time Frame
Baseline and 6-Weeks
Secondary Outcome Measure Information:
Title
Free Tryptophan (TRP)
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate.
Time Frame
Baseline and 6-Weeks
Title
Kynurenic Acid (KYNA)
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. MS* AUC is mass spectrometry times area under the curve.
Time Frame
Baseline and 6-Weeks
Title
Kynurenine (KYN)
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate.
Time Frame
Baseline and 6-Weeks
Title
Picolinic Acid (PIC)
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. MS* AUC is mass spectrometry times area under the curve.
Time Frame
Baseline and 6-Weeks
Title
KYN/TRP
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.
Time Frame
Baseline and 6-Weeks
Title
KYNA/KYN
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.
Time Frame
Baseline and 6-Weeks
Title
PIC/KYN
Description
The secondary outcome measure will be change in metabolite values. Values were collected in triplicate. AUC ratio reported.
Time Frame
Baseline and 6-Weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be male or female aged 18 to 55 years (inclusive). Have a DSM-5 diagnosis of schizophrenia or schizoaffective disorder confirmed by medical records. Duration of illness must be ≥ 1year. Be clinically stable for at least two months (i.e., has no more than a "moderately severe" severity rating on the following BPRS items: hallucination, unusual thought content and conceptual disorganization. Have not had a psychiatric hospitalization in the two months prior to screening. Be taking any 1st generation antipsychotic prescribed in the absence of a concomitant anticholinergic or 2nd generation antipsychotic and minimal extrapyramidal symptoms Have a Simpson-Angus Score (SAS) < 6 Be on current medication regimen for at least six weeks before screening at stable dose and frequency for at least 30 days before screening. Be in good general health and expected to complete the clinical study as designed. Subjects of childbearing potential must agree to use two forms of non-hormonal contraception (dual contraception) consistently during the screening and treatment periods of the trial, and for 30 days after the final dose of the study medications. Females of child-bearing potential must have a negative urine pregnancy test at baseline. This may also be done at subsequent visits if subject reports possibility of pregnancy. Have a negative urine drug screen at screening. This may be repeated at the discretion of the primary investigator. Have adequate hearing, vision, and language skills to perform the procedures specified in the protocol. Be capable of providing informed consent and have voluntarily provided informed consent. Exclusion Criteria: Have an active, clinically significant unstable medical condition with 30 days prior to screening. Have dementia. Are pregnant, breastfeeding, or planning to become pregnant Are taking or thinking about taking oral contraceptives or an injectable contraceptive. Are taking benztropine at a dose greater than 2 mg daily. Have a history of Pervasive Development Disorder. Have a history of significant head injury/trauma (defined by one of more of the following: loss of consciousness for more than one hour; recurring seizures resulting from the head injury; and/or clear cognitive sequelae of the injury requiring cognitive rehabilitation.) Have an allergy to anticholinesterase medications (galantamine, rivastigimine, donepezil) and memantine Have a DSM-5 diagnosis of alcohol and/or substance use disorder (other than caffeine and tobacco) within the last 6 months. Are taking a restricted medication: Amitriptyline, Doxepin, Imipramine, Flexeril, Clozapine, and/or cortisol (any oral, injectable, or topical steroid medication) Have a history of seizures excluding a childhood febrile seizure Have received ECT within the last three months prior to screening. Have participated in a clinical trial of any other psychotropic medication within last two months prior to screening. Have a "severe" or "extremely severe" severity rating on the BPRS items: hallucination or unusual thought content. Have more than a "moderate" severity rating on the BPRS item conceptual disorganization . Are currently taking 3 or more antipsychotic medications.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maju M. Koola, MD
Organizational Affiliation
Sheppard Pratt Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sheppard Pratt Health System
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21204
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
24878431
Citation
Koola MM, Buchanan RW, Pillai A, Aitchison KJ, Weinberger DR, Aaronson ST, Dickerson FB. Potential role of the combination of galantamine and memantine to improve cognition in schizophrenia. Schizophr Res. 2014 Aug;157(1-3):84-9. doi: 10.1016/j.schres.2014.04.037. Epub 2014 May 28.
Results Reference
background
PubMed Identifier
27069875
Citation
Koola MM. Kynurenine pathway and cognitive impairments in schizophrenia: Pharmacogenetics of galantamine and memantine. Schizophr Res Cogn. 2016 Jun;4:4-9. doi: 10.1016/j.scog.2016.02.001.
Results Reference
background
PubMed Identifier
28705532
Citation
Koola MM, Sklar J, Davis W, Nikiforuk A, Meissen JK, Sawant-Basak A, Aaronson ST, Kozak R. Kynurenine pathway in schizophrenia: Galantamine-memantine combination for cognitive impairments. Schizophr Res. 2018 Mar;193:459-460. doi: 10.1016/j.schres.2017.07.005. Epub 2017 Jul 11. No abstract available.
Results Reference
result

Learn more about this trial

Galantamine and Memantine Combination for Cognitive Impairments in Schizophrenia

We'll reach out to this number within 24 hrs