search
Back to results

Aripiprazole Augmentation for Clozapine-Treated Patients With Refractory Schizophrenia

Primary Purpose

Schizophrenia

Status
Completed
Phase
Phase 4
Locations
Korea, Republic of
Study Type
Interventional
Intervention
aripiprazole
placebo
Sponsored by
Seoul National University Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Schizophrenia focused on measuring schizophrenia, aripiprazole, clozapine

Eligibility Criteria

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

Inclusion Criteria: Male or female patients, 18-65 years of age. Patients must have a diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Female patients of menarche must be using a medically accepted means of contraception (e.g. oral contraceptives, Depo-Provera, abstinence). Each patient must provide written informed consent after full explanation of study protocol, and authorized legal guardian must understand the nature of the study and must also give assent to study participation. Patients must have a baseline (day 0) BPRS score of at least 35 or over 2 of 5 SANS global rating item scores of at least 3. Patients have been receiving clozapine treatment for more than 1 year and there has been no change in clozapine dosage for more than 3 months. Patients must have a history of antipsychotic treatment with at least 2 different kinds prior to clozapine administration. Subjects who are fluent in Korean. Exclusion Criteria: DSM-IV substance (except nicotine or caffeine) dependence within the past 1 year. Female patients who are either pregnant or lactating. Mental retardation (IQ < 70). Neurological disorders including epilepsy, stroke, or severe head trauma. Clinically significant laboratory abnormalities, on any of the following tests: CBC with differential, electrolytes, BUN, creatinine, hepatic transaminases, urinalysis and EKG. Prior history of aripiprazole non-response or intolerance. BPRS score of < 35 and over 4 of 5 SANS global rating item scores of < 3. Participation in a clinical trial of another investigational drug within 3 months (90 days) prior to study entry. Treatment with an injectable depot neuroleptic within less than three dosing interval between the last depot neuroleptic injections and baseline (day 0). History of electroconvulsive therapy within the past 3 months. Subjects who are not fluent in Korean.

Sites / Locations

  • Seoul National University Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

A

B

Arm Description

clozapine plus aripiprazole

clozapine plus placebo

Outcomes

Primary Outcome Measures

Brief Psychotic Rating Scale (BPRS): Measure of efficacy will be changes in BPRS total and subscale scores from baseline to 8th week endpoint. Follow-up evaluation will be made every 6th month till 1 year after 8th week end point.
Schedule for Assessment of Negative Symptoms (SANS): Measure of efficacy will be changes in SANS total and subscale scores from baseline to 8th week endpoint. Follow-up evaluation will be made at 6 month and 12 month after 8th week end point.
Serum Prolactin Level
Body Mass Index & Abdominal Circumference
Lipid Panel with LDL Cholesterol
FBS-PP & HbA1c

Secondary Outcome Measures

Clinical Global Impression-Severity & Improvement (CGI-S & CGI-I)
Montgomery-Asberg Depression Rating Scale (MADRS)
Yale-Brown Obsessive Compulsive Scale (YBOCS)
Subjective Well-being under Neuroleptics scale (SWN)
Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS)
Udvalg Fur Kliniske Undersogesler (UKU)
Blood Pressure and Pulse Rate
Admission Battery, CBC, & EKG
Serum Clozapine Level
Quantitative Electroencephalogram

Full Information

First Posted
May 17, 2006
Last Updated
October 28, 2008
Sponsor
Seoul National University Hospital
Collaborators
Korea Otsuka Pharmaceutical Co., Ltd.
search

1. Study Identification

Unique Protocol Identification Number
NCT00328367
Brief Title
Aripiprazole Augmentation for Clozapine-Treated Patients With Refractory Schizophrenia
Official Title
A Double-Blind Randomized Placebo Controlled Study of Aripiprazole Augmentation for Clozapine-Treated Patients With Refractory Schizophrenia
Study Type
Interventional

2. Study Status

Record Verification Date
April 2008
Overall Recruitment Status
Completed
Study Start Date
December 2005 (undefined)
Primary Completion Date
December 2006 (Actual)
Study Completion Date
February 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Seoul National University Hospital
Collaborators
Korea Otsuka Pharmaceutical Co., Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine whether aripiprazole augmentation is safe and effective in the treatment of clozapine-treated patients with refractory schizophrenia.
Detailed Description
Clozapine is renowned for its efficacy in treating schizophrenia refractory to typical or atypical antipsychotics. Though the effectiveness of clozapine has been established, a considerable number of patients with schizophrenia are partially responsive or unresponsive to clozapine. In addition, long-term use of clozapine is associated with the development of obsessive-compulsive symptoms and metabolic syndrome. In order to overcome these short-comings and to increase efficacy, aripiprazole augmentation was implemented. Quantitative electroencephalogram will be used to monitor the occurrence of abnormal findings and to analyze the changes in electroencephalographic pattern with linear and non-linear methodology. Comparisons: Design of double-blind randomized placebo controlled study of patients at Refractory Schizophrenia Clinique in Department of Neuropsychiatry at Seoul National University Hospital.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Schizophrenia
Keywords
schizophrenia, aripiprazole, clozapine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
61 (Actual)

8. Arms, Groups, and Interventions

Arm Title
A
Arm Type
Experimental
Arm Description
clozapine plus aripiprazole
Arm Title
B
Arm Type
Placebo Comparator
Arm Description
clozapine plus placebo
Intervention Type
Drug
Intervention Name(s)
aripiprazole
Other Intervention Name(s)
abilify, OPC-14597
Intervention Description
aripiprazole augmentation of clozapine
Intervention Type
Drug
Intervention Name(s)
placebo
Intervention Description
placebo
Primary Outcome Measure Information:
Title
Brief Psychotic Rating Scale (BPRS): Measure of efficacy will be changes in BPRS total and subscale scores from baseline to 8th week endpoint. Follow-up evaluation will be made every 6th month till 1 year after 8th week end point.
Time Frame
one year
Title
Schedule for Assessment of Negative Symptoms (SANS): Measure of efficacy will be changes in SANS total and subscale scores from baseline to 8th week endpoint. Follow-up evaluation will be made at 6 month and 12 month after 8th week end point.
Time Frame
one year
Title
Serum Prolactin Level
Time Frame
one year
Title
Body Mass Index & Abdominal Circumference
Time Frame
one year
Title
Lipid Panel with LDL Cholesterol
Time Frame
one year
Title
FBS-PP & HbA1c
Time Frame
one year
Secondary Outcome Measure Information:
Title
Clinical Global Impression-Severity & Improvement (CGI-S & CGI-I)
Time Frame
one year
Title
Montgomery-Asberg Depression Rating Scale (MADRS)
Time Frame
one year
Title
Yale-Brown Obsessive Compulsive Scale (YBOCS)
Time Frame
one year
Title
Subjective Well-being under Neuroleptics scale (SWN)
Time Frame
one year
Title
Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS)
Time Frame
one year
Title
Udvalg Fur Kliniske Undersogesler (UKU)
Time Frame
one year
Title
Blood Pressure and Pulse Rate
Time Frame
one year
Title
Admission Battery, CBC, & EKG
Time Frame
one year
Title
Serum Clozapine Level
Time Frame
one year
Title
Quantitative Electroencephalogram
Time Frame
one year

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 patients, 18-65 years of age. Patients must have a diagnosis of schizophrenia according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Female patients of menarche must be using a medically accepted means of contraception (e.g. oral contraceptives, Depo-Provera, abstinence). Each patient must provide written informed consent after full explanation of study protocol, and authorized legal guardian must understand the nature of the study and must also give assent to study participation. Patients must have a baseline (day 0) BPRS score of at least 35 or over 2 of 5 SANS global rating item scores of at least 3. Patients have been receiving clozapine treatment for more than 1 year and there has been no change in clozapine dosage for more than 3 months. Patients must have a history of antipsychotic treatment with at least 2 different kinds prior to clozapine administration. Subjects who are fluent in Korean. Exclusion Criteria: DSM-IV substance (except nicotine or caffeine) dependence within the past 1 year. Female patients who are either pregnant or lactating. Mental retardation (IQ < 70). Neurological disorders including epilepsy, stroke, or severe head trauma. Clinically significant laboratory abnormalities, on any of the following tests: CBC with differential, electrolytes, BUN, creatinine, hepatic transaminases, urinalysis and EKG. Prior history of aripiprazole non-response or intolerance. BPRS score of < 35 and over 4 of 5 SANS global rating item scores of < 3. Participation in a clinical trial of another investigational drug within 3 months (90 days) prior to study entry. Treatment with an injectable depot neuroleptic within less than three dosing interval between the last depot neuroleptic injections and baseline (day 0). History of electroconvulsive therapy within the past 3 months. Subjects who are not fluent in Korean.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yong Sik Kim, MD, PhD
Organizational Affiliation
Seoul National University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Seoul National University Hospital
City
Seoul
ZIP/Postal Code
110-744
Country
Korea, Republic of

12. IPD Sharing Statement

Citations:
PubMed Identifier
16647796
Citation
Rocha FL, Hara C. Benefits of combining aripiprazole to clozapine: three case reports. Prog Neuropsychopharmacol Biol Psychiatry. 2006 Aug 30;30(6):1167-9. doi: 10.1016/j.pnpbp.2006.03.024. Epub 2006 May 2.
Results Reference
background
PubMed Identifier
16423166
Citation
Henderson DC, Kunkel L, Nguyen DD, Borba CP, Daley TB, Louie PM, Freudenreich O, Cather C, Evins AE, Goff DC. An exploratory open-label trial of aripiprazole as an adjuvant to clozapine therapy in chronic schizophrenia. Acta Psychiatr Scand. 2006 Feb;113(2):142-7. doi: 10.1111/j.1600-0447.2005.00612.x.
Results Reference
background
PubMed Identifier
16168043
Citation
Ziegenbein M, Sieberer M, Calliess IT, Kropp S. Combination of clozapine and aripiprazole: a promising approach in treatment-resistant schizophrenia. Aust N Z J Psychiatry. 2005 Sep;39(9):840-1. doi: 10.1111/j.1440-1614.2005.01688_2.x. No abstract available.
Results Reference
background
PubMed Identifier
18370574
Citation
Chang JS, Ahn YM, Park HJ, Lee KY, Kim SH, Kang UG, Kim YS. Aripiprazole augmentation in clozapine-treated patients with refractory schizophrenia: an 8-week, randomized, double-blind, placebo-controlled trial. J Clin Psychiatry. 2008 May;69(5):720-31. doi: 10.4088/jcp.v69n0505.
Results Reference
derived
Links:
URL
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a603012.html
Description
Click here for detailed information about aripiprazole.

Learn more about this trial

Aripiprazole Augmentation for Clozapine-Treated Patients With Refractory Schizophrenia

We'll reach out to this number within 24 hrs