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Add-on Dextromethorphan in Bipolar Disorders (DM)

Primary Purpose

Bipolar Disorder

Status
Completed
Phase
Phase 3
Locations
Taiwan
Study Type
Interventional
Intervention
Valproate
Dextromethorphan 60 mg per day
Placebo
Dextromethorphan 30 mg
Sponsored by
National Cheng-Kung University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bipolar Disorder

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female patient aged ≧18 and ≦65 years.
  2. A diagnosis of bipolar I or II disorder according to DSM-IV criteria made by a specialist in psychiatry.
  3. A total of HDRS score at least 18 or YMRS score at least 14 at screen.
  4. Signed informed consent by patient or legal representative
  5. Patient or a reliable caregiver can be expected to ensure acceptable compliance and visit attendance for the duration of the study.

Exclusion Criteria:

  1. Women of childbearing potential not using adequate contraception as per investigator judgment or not willing to comply with contraception for duration of study.
  2. Females who are pregnant or nursing.
  3. Patient has received dextromethorphan, or other selective cyclo- oxygenase 2 (Cox-2) inhibitors, or other anti-inflammatory medication within 1 week prior to first dose of double-blind medication.
  4. Axis-I DSM-IV diagnosis other than bipolar I or II disorder.
  5. Current evidence of an uncontrolled and/or clinically significant medical condition (e.g., cardiac, hepatic and renal failure), which in the judgments of the investigator, would compromise patient safety or preclude study participation.
  6. History of intolerance to valproate or dextromethorphan or other Cox-2 inhibitors.
  7. History of sensitivity reaction (e.g., urticaria, angioedema, bronchospasm, severe rhinitis, anaphylactic shock) precipitated by dextromethorphan.
  8. Patient has received electroconvulsive therapy (ECT) within 4 weeks prior to first dose of doubleblind medication.
  9. Diagnosis of or treatment for esophageal, gastric, pyloric channel, or duodenal ulceration or related complications (bleeding and/or perforation) within 30 days prior to receiving first dose of double-blind medication.
  10. Inclusion in another bipolar disorder study or study for another indication with psychotropic's within the last 30 days prior to start of study.
  11. Increase in total SGOT, SGPT, BUN and creatinine by more than 3X ULN (upper limit of normal).
  12. History of idiopathic or drug-induced agranulocytosis.
  13. Substance-related disorders within 6 months prior to study start, borderline personality disorder, schizophrenia, or other major psychiatric disorders as defined by DSM-IV criteria.

Sites / Locations

  • Ru-Band Lu

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

Valproate & dextromethorphan 30 mg

VPA & dextromethorphan 60 mg

VPA & Placebo

Arm Description

Valproate and dextromethorphan 30 mg per day

VPA & dextromethorphan 60 mg per day

VPA & placebo

Outcomes

Primary Outcome Measures

Young's Mania Rating Scale (YMRS)
The severity of current manic symptoms will be assessed by using the YMRS
Hamilton Depression Rating Scale (HDRS)
The severity of depressive symptoms will be evaluated by HDRS

Secondary Outcome Measures

blood samples
The immune markers, cytokines will be measured at each time point to follow each patient's changes.
lipid profiles

Full Information

First Posted
August 23, 2010
Last Updated
September 16, 2013
Sponsor
National Cheng-Kung University Hospital
Collaborators
National Health Research Institutes, Taiwan, TTY Biopharm
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1. Study Identification

Unique Protocol Identification Number
NCT01188265
Brief Title
Add-on Dextromethorphan in Bipolar Disorders
Acronym
DM
Official Title
Dextromethorphan Enhances the Therapeutic Efficacy of Valoproate in Bipolar Disorder Patients
Study Type
Interventional

2. Study Status

Record Verification Date
September 2013
Overall Recruitment Status
Completed
Study Start Date
June 2007 (undefined)
Primary Completion Date
December 2010 (Actual)
Study Completion Date
June 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Cheng-Kung University Hospital
Collaborators
National Health Research Institutes, Taiwan, TTY Biopharm

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Dextromethorphan has been reported affording neuroprotection on dopaminergic neurons and having protective effect against inflammation-related neuron damage. These anti-inflammatory and neuroprotective effects of dextromethorphan would suggest potential clinical benefits of dextromethorphan add-on therapy to valproate for bipolar disorder patients. This hypothesis was based on the findings that the mood stabilizers have been reported to be neuroprotective through the release of neurotrophic factors such as GDNF from astroglia. Thus, the combination treatment of mood stabilizers and dextromethorphan might improve the therapeutic efficacy for bipolar disorder patients.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
300 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Valproate & dextromethorphan 30 mg
Arm Type
Experimental
Arm Description
Valproate and dextromethorphan 30 mg per day
Arm Title
VPA & dextromethorphan 60 mg
Arm Type
Experimental
Arm Description
VPA & dextromethorphan 60 mg per day
Arm Title
VPA & Placebo
Arm Type
Active Comparator
Arm Description
VPA & placebo
Intervention Type
Drug
Intervention Name(s)
Valproate
Intervention Type
Drug
Intervention Name(s)
Dextromethorphan 60 mg per day
Intervention Description
VPA plus dextromethorphan 60 mg per day
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
VPA plus placebo
Intervention Type
Drug
Intervention Name(s)
Dextromethorphan 30 mg
Intervention Description
VPA & Dextromethorphan 30 mg per day
Primary Outcome Measure Information:
Title
Young's Mania Rating Scale (YMRS)
Description
The severity of current manic symptoms will be assessed by using the YMRS
Time Frame
baseline, 1, 2, 4, 8 and 12 weeks
Title
Hamilton Depression Rating Scale (HDRS)
Description
The severity of depressive symptoms will be evaluated by HDRS
Time Frame
baseline, 1, 2, 4, 8 and 12 weeks
Secondary Outcome Measure Information:
Title
blood samples
Description
The immune markers, cytokines will be measured at each time point to follow each patient's changes.
Time Frame
baseline, 1, 2, 4, 8 and 12 weeks
Title
lipid profiles
Time Frame
baseline, after treatment

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: Male or female patient aged ≧18 and ≦65 years. A diagnosis of bipolar I or II disorder according to DSM-IV criteria made by a specialist in psychiatry. A total of HDRS score at least 18 or YMRS score at least 14 at screen. Signed informed consent by patient or legal representative Patient or a reliable caregiver can be expected to ensure acceptable compliance and visit attendance for the duration of the study. Exclusion Criteria: Women of childbearing potential not using adequate contraception as per investigator judgment or not willing to comply with contraception for duration of study. Females who are pregnant or nursing. Patient has received dextromethorphan, or other selective cyclo- oxygenase 2 (Cox-2) inhibitors, or other anti-inflammatory medication within 1 week prior to first dose of double-blind medication. Axis-I DSM-IV diagnosis other than bipolar I or II disorder. Current evidence of an uncontrolled and/or clinically significant medical condition (e.g., cardiac, hepatic and renal failure), which in the judgments of the investigator, would compromise patient safety or preclude study participation. History of intolerance to valproate or dextromethorphan or other Cox-2 inhibitors. History of sensitivity reaction (e.g., urticaria, angioedema, bronchospasm, severe rhinitis, anaphylactic shock) precipitated by dextromethorphan. Patient has received electroconvulsive therapy (ECT) within 4 weeks prior to first dose of doubleblind medication. Diagnosis of or treatment for esophageal, gastric, pyloric channel, or duodenal ulceration or related complications (bleeding and/or perforation) within 30 days prior to receiving first dose of double-blind medication. Inclusion in another bipolar disorder study or study for another indication with psychotropic's within the last 30 days prior to start of study. Increase in total SGOT, SGPT, BUN and creatinine by more than 3X ULN (upper limit of normal). History of idiopathic or drug-induced agranulocytosis. Substance-related disorders within 6 months prior to study start, borderline personality disorder, schizophrenia, or other major psychiatric disorders as defined by DSM-IV criteria.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ru-Band Lu, MD
Organizational Affiliation
National Cheng-Kung University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Ru-Band Lu
City
Tainan
ZIP/Postal Code
704
Country
Taiwan

12. IPD Sharing Statement

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Add-on Dextromethorphan in Bipolar Disorders

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