Adjuvant Therapy With Pergolide in Treating Cognitive Deficits in Schizophrenia
Primary Purpose
Schizophrenia
Status
Completed
Phase
Not Applicable
Locations
Germany
Study Type
Interventional
Intervention
Pergolide
Sponsored by
About this trial
This is an interventional basic science trial for Schizophrenia focused on measuring schizophrenia, cognitive deficits, dopamine, dopamine agonists, prefrontal cortex, D1 specific modulation, pergolide, executive control, working memory, Influence of pergolide on cognition in Schizophrenia, D1-specific modulation of prefrontal functions, Influence of pergolide on psychopathology and depression, Influence of pergolide on extrapyramidal symptoms
Eligibility Criteria
Inclusion Criteria:
- Non-acute in- and outpatients, with predominantly negative symptoms, and remitted from positive symptoms like hallucinations and delusions for 1 week, with the diagnosis of schizophrenia (ICD 10: F20) at the Psychiatry Hospital of the Universities of Heidelberg, Hamburg-Eppendorf, Zentralinstitut für Seelische Gesundheit Mannheim, SRH Klinikum Karlsbad - Langensteinbach (Clinical interview to establish diagnosis with DSM-IV (M.I.N.I International Neuropsychiatric Interview _ German Version 5.0.0)
- Verbal IQ higher than 80, as measured by the Mehrfachwahl-Wortschatz-Intelligenztest
- Visual acuity must be normal or corrected.
- Color sight intact
- Positive neuroleptics drug monitoring level
- Females must be under adequate contraception (oral hormonal contraceptive, IntraUterineDevice)
Exclusion Criteria:
- Concomitant neurologic and internistic diseases (especially cardiovascular diseases and others like untreated thyroid hyper-/hypofunction, liver or kidney dysfunction, seizures or history of traumatic brain injury)
- Known allergy reaction under ergoline-therapy
- Actual history of drug abuse/addiction, concomitant other psychiatric disorder (screened by SCID) and suicide attempt in the medical history
- Other long term pharmacological treatment which can interact with dopamine agonists and antagonists (e.g. anticoagulants, digitoxin)
- Pregnancy and breastfeeding (anamneses and pregnancy test in urine)
- Participation in other clinical trial for the last 3 months
- History of malignant neuroleptic syndrome
Sites / Locations
- Zentralinstitut für Seelische Gesundheit
- Psychiatrische Universitätsklinik
- Universitätsklinikum Hamburg - Eppendorf
- SRH Klinikum Karlsbad - Langensteinbach gGmbH
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Pergolide
Arm Description
Patients will be randomly assigned to a sequence of treatments of either pergolide or placebo p.o. under continuous concomitant atypical neuroleptic therapy (stable at least 2 weeks prior trial begin).
Outcomes
Primary Outcome Measures
The D1-specific dopaminergic modulation of prefrontal functions (executive control, working memory, control of semantic association) confirmed by a complex neuropsychological battery including a non - PFC activating control task
Secondary Outcome Measures
Influence of pergolide on psychopathology symptoms and extrapyramidal symptoms in comparison to placebo measured by specific rating scales, e.g. PANSS and Calgary Depression Scale
Full Information
NCT ID
NCT01066403
First Posted
February 9, 2010
Last Updated
February 9, 2010
Sponsor
Heidelberg University
Collaborators
Stanley Medical Research Institute
1. Study Identification
Unique Protocol Identification Number
NCT01066403
Brief Title
Adjuvant Therapy With Pergolide in Treating Cognitive Deficits in Schizophrenia
Official Title
Dopaminergic Modulation of Prefrontal Functions in Schizophrenic Patients: Adjuvant Therapy With Pergolide
Study Type
Interventional
2. Study Status
Record Verification Date
December 2008
Overall Recruitment Status
Completed
Study Start Date
October 2003 (undefined)
Primary Completion Date
March 2008 (Actual)
Study Completion Date
March 2008 (Actual)
3. Sponsor/Collaborators
Name of the Sponsor
Heidelberg University
Collaborators
Stanley Medical Research Institute
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The objective of this study is to compare the modulation of pergolide, a D1/D2 receptor agonist, to placebo in non-acute schizophrenic subjects under concomitant therapy with atypical antipsychotics on specific PFC functions. Further aims are to assess the influence of pergolide on psychopathology and extrapyramidal symptoms in comparison to placebo.
Detailed Description
Additionally to the desired treatment of positive symptoms, the administration of typical neuroleptics can lead to undesired side effects such as increase of negative symptomatic and cognitive deficits. The influence of atypical neuroleptics on cognition is still not very well studied. Furthermore there is evidence that some cognitive symptoms seen in schizophrenia are related to a disturbance in the prefrontal cortex PFC and involve specific subtypes of dopamine receptors, namely D1 subtypes, which predominates in this area. It is assumed that patients with this spectrum of cognitive deficits have the worse course and prognosis. Furthermore these deficits are more therapy resistant to the conventional current therapy approaches. There is however some evidence pointing to a positive influence of dopamine agonists on these deficits, but the selective effect of dopamine sub-receptors is still not well investigated. The aim of the study is to examine whether cognitive deficits in higher cognitive functions of the PFC such as working memory, semantic association and executive control improves under dopamine agonistic therapy in schizophrenia and whether this is related to selective D1 modulation.
We predict that the modulation of D1 subtype receptors improve performance in each of these tasks. Because there is no D1 agonist available for human research we decided to use a design comparing a dopamine agonist with mixed D1 and D2 agonistic properties (pergolide) to placebo under a stable D2 antagonistic continuous-therapy with atypical antipsychotics. With this design the D2-component of pergolide can be antagonized by the atypical antipsychotics and a D1 agonistic effect can be suggested, as well as protecting patients against a psychotic re-exacerbation. With this study we aim to bring more insight in the therapy of PFC cognitive deficits of schizophrenia by helping to elucidate the role of selective agonists on cognition in schizophrenic patients. I
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia
Keywords
schizophrenia, cognitive deficits, dopamine, dopamine agonists, prefrontal cortex, D1 specific modulation, pergolide, executive control, working memory, Influence of pergolide on cognition in Schizophrenia, D1-specific modulation of prefrontal functions, Influence of pergolide on psychopathology and depression, Influence of pergolide on extrapyramidal symptoms
7. Study Design
Primary Purpose
Basic Science
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Pergolide
Arm Type
Experimental
Arm Description
Patients will be randomly assigned to a sequence of treatments of either pergolide or placebo p.o. under continuous concomitant atypical neuroleptic therapy (stable at least 2 weeks prior trial begin).
Intervention Type
Drug
Intervention Name(s)
Pergolide
Other Intervention Name(s)
Parkotil, Pergolid
Intervention Description
0,3 mg pergolide (the first two days begin with 0,05mg, then increase of dose of 0,1mg every 3 days for a maximum of 0,3mg/d, taken orally 3x 0,1mg/day). Then stable dose of 0,3mg for one week.. Subsequently slow (for 8 days) reduction of dosage of 0,1mg every 3 days for 6 days then 0,05mg every day for the last two days.
Placebo group is identical in appearance and number of placebo capsules, in the same starting and maintenance scheme as for the pergolide group.
Primary Outcome Measure Information:
Title
The D1-specific dopaminergic modulation of prefrontal functions (executive control, working memory, control of semantic association) confirmed by a complex neuropsychological battery including a non - PFC activating control task
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Influence of pergolide on psychopathology symptoms and extrapyramidal symptoms in comparison to placebo measured by specific rating scales, e.g. PANSS and Calgary Depression Scale
Time Frame
30 days
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:
Non-acute in- and outpatients, with predominantly negative symptoms, and remitted from positive symptoms like hallucinations and delusions for 1 week, with the diagnosis of schizophrenia (ICD 10: F20) at the Psychiatry Hospital of the Universities of Heidelberg, Hamburg-Eppendorf, Zentralinstitut für Seelische Gesundheit Mannheim, SRH Klinikum Karlsbad - Langensteinbach (Clinical interview to establish diagnosis with DSM-IV (M.I.N.I International Neuropsychiatric Interview _ German Version 5.0.0)
Verbal IQ higher than 80, as measured by the Mehrfachwahl-Wortschatz-Intelligenztest
Visual acuity must be normal or corrected.
Color sight intact
Positive neuroleptics drug monitoring level
Females must be under adequate contraception (oral hormonal contraceptive, IntraUterineDevice)
Exclusion Criteria:
Concomitant neurologic and internistic diseases (especially cardiovascular diseases and others like untreated thyroid hyper-/hypofunction, liver or kidney dysfunction, seizures or history of traumatic brain injury)
Known allergy reaction under ergoline-therapy
Actual history of drug abuse/addiction, concomitant other psychiatric disorder (screened by SCID) and suicide attempt in the medical history
Other long term pharmacological treatment which can interact with dopamine agonists and antagonists (e.g. anticoagulants, digitoxin)
Pregnancy and breastfeeding (anamneses and pregnancy test in urine)
Participation in other clinical trial for the last 3 months
History of malignant neuroleptic syndrome
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Daniela Roesch - Ely, MD
Organizational Affiliation
Psychiatrische Universitätsklinik Heidelberg
Official's Role
Principal Investigator
Facility Information:
Facility Name
Zentralinstitut für Seelische Gesundheit
City
Mannheim
State/Province
68159
Country
Germany
Facility Name
Psychiatrische Universitätsklinik
City
Heidelberg
State/Province
BW
ZIP/Postal Code
69115
Country
Germany
Facility Name
Universitätsklinikum Hamburg - Eppendorf
City
Hamburg
ZIP/Postal Code
20246
Country
Germany
Facility Name
SRH Klinikum Karlsbad - Langensteinbach gGmbH
City
Karlsbad
ZIP/Postal Code
76307
Country
Germany
12. IPD Sharing Statement
Links:
URL
http://www.klinikum.uni-heidelberg.de/Dopamin-und-Schizophrenie.5472.0.html
Description
Related Info
URL
http://www.ncbi.nlm.nih.gov/pubmed/16721703?ordinalpos=8&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
Description
Related Info
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Adjuvant Therapy With Pergolide in Treating Cognitive Deficits in Schizophrenia
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