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Enhancing Recovery in Early Schizophrenia

Primary Purpose

Schizophrenia

Status
Recruiting
Phase
Phase 2
Locations
Germany
Study Type
Interventional
Intervention
Cannabidiol as add-on
Placebo as add-on
Sponsored by
Central Institute of Mental Health, Mannheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia

Eligibility Criteria

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

Inclusion Criteria:

  • Informed consent given by the subject
  • DSM-IV-TR diagnosis of schizophrenic psychosis (295.10-30, 295.90)
  • First documented diagnosis of schizophrenia must not be no older than seven years.
  • Patients must receive a stable dose of amisulpride, aripiprazole, olanzapine, quetiapine or risperidone (TAU: treatment as usual) at least 4 weeks prior to inclusion in the study to ensure that the maximal effect of the previous medication has been received.
  • Initial PANSS total score of ≤ 75 at baseline.
  • proper contraception in female patients of childbearing potential
  • body mass index between 18 and 40.

Exclusion Criteria:

  • Lack of accountability
  • positive urine drug-screening for illicit drugs at screening (except cannabinoids and benzodiazepines)
  • serious suicidal risk at screening visit
  • other relevant interferences of axis 1 according to diagnostic evaluation (MINI) including residual forms of schizophrenia.
  • other relevant neurological or other medical disorders
  • pregnancy or lactation.

Sites / Locations

  • Dep. of Psychiatry and Psychotherapy, Central Institute of Mental HealthRecruiting
  • Dept. of Psychiatry and Psychotherapy, Ludwig-Maximillians-University Munich
  • Dept. of Psychiatry and Psychotherapy, Charité, Campus Charité-MitteRecruiting
  • Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH AachenRecruiting
  • Dept. of Psychiatry and Psychotherapy, University Hospital of CologneRecruiting
  • Department of Psychiatry und Psychotherapy, University Hospital Hamburg-EppendorfRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Cannabidiol

Placebo

Arm Description

Cannabidiol as add-on to individualized pharmacological treatment

Placebo as add-on to individualized pharmacological treatment

Outcomes

Primary Outcome Measures

All-cause discontinuation

Secondary Outcome Measures

Improvement in Psychopathology assessed by PANSS
Positive and Negative Syndrome Scale (PANSS)
Improvement in Psychopathology assessed by CGI
Clinical Global Impression (CGI)
Improvement in Psychopathology assessed by BSI-53
Brief Symptom Inventory (BSI-53)
Improvement in Psychopathology assessed by FROGS
Functional Remission of General Schizophrenia (FROGS)
Changes from baseline in Depression Scale
Calgary Depression Scale for Schizophrenia (CDSS)
Improvement in social and occupational functioning assessed by GAF
Global Assessment of Functioning (GAF)
Improvement in social and occupational functioning assessed by PSP
Personal and Social Performance Scale (PSP)
Improvement in social and occupational functioning assessed by EMA
Ecological Momentary Assessment (EMA)
Improvement in Quality of life assessed by WHOQUOL-Bref
WHO Quality of Life-Bref (WHOQUOL-Bref)
Improvement in Quality of life assessed by LQLP
Lancashire Quality of Life Profile (LQLP)
Changes from baseline in Neurocognition assessed by B-CATS
Brief Cognitive Assessment Tool for Schizophrenia (B-CATS)
Changes from baseline in Neurocognition assessed by BACS
Brief Assessment of Cognition in Schizophrenia (BACS)
Changes from baseline in Neurocognition assessed by UPSA-B
University of California San Diego Performance based Skills Assessment (UPSA-B)
Changes from baseline in Neurocognition assessed by MASC
Movie for the Assessment of Social Cognition (MASC)
Changes from baseline in Neurocognition assessed by PFA
Pictures of Facial Affect (PFA)
Treatment adherence
Changes in Cumulative dose of concomitant or rescue medication
Changes of Biomarker: alterations of endocannabinoids and lipdomic profiling

Full Information

First Posted
July 7, 2016
Last Updated
September 20, 2023
Sponsor
Central Institute of Mental Health, Mannheim
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1. Study Identification

Unique Protocol Identification Number
NCT02926859
Brief Title
Enhancing Recovery in Early Schizophrenia
Official Title
Enhancing Recovery in Early Schizophrenia - a Multi-center, Two-arm, Double-blind, Randomized Phase II Trial Investigating Cannabidiol vs. Placebo as an add-on to an Individualized Antipsychotic Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 8, 2017 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Central Institute of Mental Health, Mannheim

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Current antipsychotic treatments of schizophrenia are only partially effective, and their use is often associated with serious side effects. Cannabidiol is a natural counterpart of the psychoactive component of marijuana, delta-9- tetrahydrocannabinol and has no psychotomimetic or addictive properties. In a controlled clinical trial of cannabidiol versus amisulpride in acute paranoid schizophrenia we showed a statistically significant clinical improvement in all symptoms clusters of schizophrenia compared to baseline with either treatment. Cannabidiol displayed a significantly superior side-effect profile in particular regarding prolactin elevation, extrapyramidal symptoms and weight gain. The favorable side-effect profile and potentially novel mechanism of action identify this molecule as a potential antipsychotic. However, long-term safety and efficacy data is still lacking. This study is to evaluate the efficacy and safety of the novel compound cannabidiol in the maintenance treatment of schizophrenia in comparison to placebo as an add-on to an established treatment with either amisulpride, aripiprazole, olanzapine, quetiapine or risperidone, in a 12-months, double-blind, parallel-group, randomized, placebo-controlled clinical trial. Thereby, relevant data on cannabidiol's antipsychotic potential will be gained.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
180 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cannabidiol
Arm Type
Experimental
Arm Description
Cannabidiol as add-on to individualized pharmacological treatment
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo as add-on to individualized pharmacological treatment
Intervention Type
Drug
Intervention Name(s)
Cannabidiol as add-on
Intervention Description
Cannabidiol capsules 2x200 mg twice a day as add-on to individualized pharmacological treatment with either amisulpride, aripiprazole, olanzapine, quetiapine or risperidone over 26 weeks
Intervention Type
Drug
Intervention Name(s)
Placebo as add-on
Intervention Description
Placebo capsules 2x200 mg twice a day as add-on to individualized pharmacological treatment with either amisulpride, aripiprazole, olanzapine, quetiapine or risperidone over 26 weeks
Primary Outcome Measure Information:
Title
All-cause discontinuation
Time Frame
within 12 month
Secondary Outcome Measure Information:
Title
Improvement in Psychopathology assessed by PANSS
Description
Positive and Negative Syndrome Scale (PANSS)
Time Frame
6, 9 and 12 month
Title
Improvement in Psychopathology assessed by CGI
Description
Clinical Global Impression (CGI)
Time Frame
6, 9 and 12 month
Title
Improvement in Psychopathology assessed by BSI-53
Description
Brief Symptom Inventory (BSI-53)
Time Frame
6, 9 and 12 month
Title
Improvement in Psychopathology assessed by FROGS
Description
Functional Remission of General Schizophrenia (FROGS)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Depression Scale
Description
Calgary Depression Scale for Schizophrenia (CDSS)
Time Frame
6, 9 and 12 month
Title
Improvement in social and occupational functioning assessed by GAF
Description
Global Assessment of Functioning (GAF)
Time Frame
6, 9 and 12 month
Title
Improvement in social and occupational functioning assessed by PSP
Description
Personal and Social Performance Scale (PSP)
Time Frame
6, 9 and 12 month
Title
Improvement in social and occupational functioning assessed by EMA
Description
Ecological Momentary Assessment (EMA)
Time Frame
6, 9 and 12 month
Title
Improvement in Quality of life assessed by WHOQUOL-Bref
Description
WHO Quality of Life-Bref (WHOQUOL-Bref)
Time Frame
6, 9 and 12 month
Title
Improvement in Quality of life assessed by LQLP
Description
Lancashire Quality of Life Profile (LQLP)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Neurocognition assessed by B-CATS
Description
Brief Cognitive Assessment Tool for Schizophrenia (B-CATS)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Neurocognition assessed by BACS
Description
Brief Assessment of Cognition in Schizophrenia (BACS)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Neurocognition assessed by UPSA-B
Description
University of California San Diego Performance based Skills Assessment (UPSA-B)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Neurocognition assessed by MASC
Description
Movie for the Assessment of Social Cognition (MASC)
Time Frame
6, 9 and 12 month
Title
Changes from baseline in Neurocognition assessed by PFA
Description
Pictures of Facial Affect (PFA)
Time Frame
6, 9 and 12 month
Title
Treatment adherence
Time Frame
6, 9 and 12 month
Title
Changes in Cumulative dose of concomitant or rescue medication
Time Frame
6, 9 and 12 month
Title
Changes of Biomarker: alterations of endocannabinoids and lipdomic profiling
Time Frame
6, 9 and 12 month
Other Pre-specified Outcome Measures:
Title
Side effects: weight gain
Description
Body Mass Index, abdominal girth
Time Frame
6, 9 and 12 month
Title
Side effects: Vital Signs
Description
heart rate, blood pressure, electrocardiography
Time Frame
6, 9 and 12 month
Title
Side effects: UKU Side Effect rating scale
Time Frame
6, 9 and 12 month
Title
Side effects: Abnormal Involuntary Movement Scale (AIMS)
Time Frame
6, 9 and 12 month
Title
Side effects: Evaluation of extrapyramidal symptoms (EPS)
Time Frame
6, 9 and 12 month
Title
Side effects: physical and neurological examination
Time Frame
6, 9 and 12 month
Title
Standard blood tests
Time Frame
6, 9 and 12 month
Title
Columbia Suicidality Sverity Rating Scale (C-SSRS)
Time Frame
6, 9 and 12 month

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: Informed consent given by the subject DSM-IV-TR diagnosis of schizophrenic psychosis (295.10-30, 295.90) First documented diagnosis of schizophrenia must not be no older than seven years. Patients must receive a stable dose of amisulpride, aripiprazole, olanzapine, quetiapine or risperidone (TAU: treatment as usual) at least 4 weeks prior to inclusion in the study to ensure that the maximal effect of the previous medication has been received. Initial PANSS total score of ≤ 75 at baseline. proper contraception in female patients of childbearing potential body mass index between 18 and 40. Exclusion Criteria: Lack of accountability positive urine drug-screening for illicit drugs at screening (except cannabinoids and benzodiazepines) serious suicidal risk at screening visit other relevant interferences of axis 1 according to diagnostic evaluation (MINI) including residual forms of schizophrenia. other relevant neurological or other medical disorders pregnancy or lactation.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
F. Markus Leweke, MD
Phone
+49 621 1703 2321
Email
leweke@cimh.de
First Name & Middle Initial & Last Name or Official Title & Degree
Cathrin Rohleder, PhD
Phone
+49 621 1703 2333
Email
rohleder@cimh.de
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
F. Markus Leweke, MD
Organizational Affiliation
Central Institute of Mental Health
Official's Role
Principal Investigator
Facility Information:
Facility Name
Dep. of Psychiatry and Psychotherapy, Central Institute of Mental Health
City
Mannheim
State/Province
BW
ZIP/Postal Code
68159
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
F. Markus Leweke, MD
Phone
+49 621 1703
Ext
2761
Email
leweke@cimh.de
First Name & Middle Initial & Last Name & Degree
F. Markus Leweke, MD
Facility Name
Dept. of Psychiatry and Psychotherapy, Ludwig-Maximillians-University Munich
City
Munich
State/Province
BY
ZIP/Postal Code
80336
Country
Germany
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Peter Falkai, MD
Email
Peter.Falkai@med.uni-muenchen.de
First Name & Middle Initial & Last Name & Degree
Peter Falkai, MD
Facility Name
Dept. of Psychiatry and Psychotherapy, Charité, Campus Charité-Mitte
City
Berlin
State/Province
B
ZIP/Postal Code
10117
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Henrik Walter, MD, PhD
Email
henrik.walter@charite.de
First Name & Middle Initial & Last Name & Degree
Henrik Walter, MD, PhD
Facility Name
Department of Psychiatry, Psychotherapy, and Psychosomatics, RWTH Aachen
City
Aachen
State/Province
NRW
ZIP/Postal Code
52074
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tanja Veselinovic, MD
Email
tveselinovic@ukaachen.de
First Name & Middle Initial & Last Name & Degree
Tanja Veselinovic, MD
Facility Name
Dept. of Psychiatry and Psychotherapy, University Hospital of Cologne
City
Cologne
State/Province
NRW
ZIP/Postal Code
50924
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Joseph Kambeitz, MD
Email
Joseph.Kambeitz@uk-koeln.de
First Name & Middle Initial & Last Name & Degree
Joseph Kambeitz, MD
Facility Name
Department of Psychiatry und Psychotherapy, University Hospital Hamburg-Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Daniel Schöttle, MD
First Name & Middle Initial & Last Name & Degree
Daniel Schöttle, MD

12. IPD Sharing Statement

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Enhancing Recovery in Early Schizophrenia

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