Active clinical trials for "Schizophrenia"

Although insight in schizophrenia spectrum disorders (SSD) has been associated with positive outcomes, the effect size of previous treatments on insight has been relatively small to date. The metacognitive basis of insight suggests that metacognitive training (MCT) may improve insight and clinical outcomes in SSD, although this remains to be established. This single-center, assessor-blind, parallel-group, randomised clinical trial (RCT) aims to investigate the efficacy of MCT for improving insight (primary outcome), including clinical and cognitive insight, which will be measured by the Schedule for Assessment of Insight (Expanded version) (SAI-E) and the Beck Cognitive Insight Scale (BCIS), respectively, in (at least) n=126 outpatients with SSD at three points in time: i) at baseline (Time 0); ii) after treatment (Time 1) and iii) at 1-year follow-up (Time 2). SSD patients receiving MCT and controls attending a non-intervention support group will be compared on insight level changes and several clinical and cognitive secondary outcomes after treatment and at follow-up, whilst adjusting for baseline data. Ecological momentary assessment (EMA) will be piloted to assess functioning in a subsample of participants. This will be the first RCT testing the effect of group MCT on multiple insight dimensions (as primary outcome) in a sample of unselected patients with SSD, including several secondary clinically relevant outcomes, namely symptom severity, functioning, which will also be evaluated with EMA, hospitalizations and suicidal behaviour.

The objective of the study is to evaluate the efficacy of Pramipexole, Minocycline and Aspirin compared to placebo, as add-on to anti-psychotics in the treatment of patients with schizophrenia.

Cannabis use by people with schizophrenia is associated with family distress and poor clinical outcomes. Therefore, an Family Motivational Intervention (FMI) was developed to help parents to motivate their child with a diagnoses of recent-onset schizophrenia to reduce cannabis use. In a single-blind randomised clinical trail with 75 patients with the diagnosis of schizophrenia, parents will be assigned to either FMI or to routine care. Assessments will be conducted at baseline and at a 10- and 22-month follow-up. The study hypothesis is that FMI will be more effective than routine care in reducing (a) cannabis use in patients and (b) distress and sense of burden in parents.

This nested design clinical outcome study of psychiatric case manager education on disease state, psychopharmacology of schizophrenia, relapse, motivational interviewing, and the process of psychological adjustment post-psychosis (Milestones of Adjustment Post-Psychosis Recovery Model-MAPP) will test the following hypotheses: Medication non-adherence in patients with schizophrenia assigned to case managers who receive MAPP training will decrease from their pre-study rate and from the reported national average after one year enrollment compared to consumers not enrolled in the MAPP arm of the study. Consumers in the MAPP intervention will have higher Quality of Life Enjoyment and Satisfaction Questionnaire (Q-Les-Q (53) scores than consumers not enrolled in the MAPP at quarterly measures. Consumers enrolled in the MAPP intervention arm of the study will successfully complete the first two phases of the MAPP Recovery Model in one year. Consumers in the MAPP intervention arm will have greater symptom reductions at quarterly data points compared to consumers not enrolled in the MAPP intervention arm.

Persistent neurocognitive deficits are a major cause of severe disability and impaired long-term psychosocial outcome in schizophrenia (SZ). In particular, within the auditory system, early deficits such as the behavioral and neurophysiological ability to match tones that vary in pitch correlate with impairments in auditory emotion recognition (affective prosody) and general functioning, suggesting that interventions aimed at remediating sensory-level dysfunction may lead to significant improvement in higher order cognitive/emotion processes. Efforts to ameliorate cognitive deficits in schizophrenia utilize either pharmacological agents or behavioral treatments such as cognitive remediation, which generally focus on higher order processes, and not on the early sensory processing which may be key to functioning. Numerous pharmacological agents have been proposed, but accumulating evidence suggests that dysfunction of the N-methyl-D-aspartic acid (NMDA) receptor may be one of the root causes of schizophrenia, including sensory and cognitive impairments, suggesting that an NMDA based treatment may be efficacious in reversing these deficits. D-Cycloserine, a synthetic partial NMDA agonist has been used in anxiety disorders to augment learning in cognitive remediation. Because of a tendency to act as an NMDA antagonist at higher doses D-cycloserine is not effective in schizophrenia. In contrast, D-serine (DSR), is a full agonist, and is therefore more ideal for enhancing NMDA function and cognitive remediation. While previous use of DSR was limited by safety concerns in rodents,the investigators have shown that it can safely be used at doses of 60 mg/kg and, moreover, demonstrates converging improvement in symptomatic, cognitive and sensory-based measures in schizophrenia. Evidence also suggests that NMDA receptor dysfunction in schizophrenia may be relative, rather than absolute, suggesting that the enhanced practice of a cognitive remediation paradigm might be able to overcome reduced plasticity and treat cognitive dysfunction. This project will be the first to combine the NMDA based and sensory-based cognitive remediation (SBR) approaches, and will utilize not only DSR, but also a tone matching SBR paradigm has been shown to enhance learning in healthy controls, as well as a paradigm designed to augment visual motion detection. This study will pilot these interventions in a double-blind, placebo-controlled, randomized crossover design that will use neurophysiology together with cognitive tests to explore the effects on brain activity and cognitive function in 16 patients with schizophrenia or schizoaffective disorder. The investigators hypothesize that DSR+SBR will lead to improvement. Subjects will have an initial visit to establish baseline performance on cognitive tasks before returning for 3 visits when they will receive blinded study medication [60 mg/kg of DSR (2 days) or placebo (1 day)] in a randomized order. The procedures on the treatment days will include the SBR paradigm and pre/post neurophysiological measurements. Primary outcomes are improvements in neurophysiologic and behavioral sensory processing. The main goal is to establish the preliminary efficacy to use in a follow-up multi-dose study utilizing a multiple session SBR R01 application.

Many patients who have recently received a diagnosis of schizophrenia (e.g., "first-episode schizophrenia") respond very well to their antipsychotic medication when they are acutely ill. Once they are more stable, research has shown that first-episode patients need to remain on their antipsychotic medication. Follow-up studies show that stopping medication prematurely is the most common cause of relapse and readmission. It is important to have new ways to help patients stay stable in the community in order for them to continue on with their rehabilitation and recovery process. Over the last decade, new antipsychotic medications have been developed that are more effective and have fewer side effects than older antipsychotics. The new medicines are often called "atypical", and were only available by pill or capsule for long-term treatment. Most recently, one of the atypical medications - risperidone - became available as a long-acting injection that can be given once every 2 weeks. The hypothesis of this study is that patients recovering from an acute episode and who then go on to receive a long-acting version of atypical antipsychotic medication (long-acting risperidone microspheres) will stay on their medications for longer than those who take their atypical medication (any available first-line atypical) in the oral (pill) form.

Use Huperzine-A, a herbal supplement normally used for treatment of Alzheimer's disease, to potentially improve cognitive dysfunction (memory problems) and functional capacity (ability to perform common daily tasks such as cooking, bathing, telephone, shopping) in people with schizophrenia.

Schizophrenia is not a curable but a treatable disease by antipsychotics. Kinds of atypical antipsychotics are widely used since 1990s' in China. Although their efficacy for acute phase are all better than typicals, individulized regimen of them for first-episode schizophrenia and their effectiveness in real naturalistic clinical settings still remain unclear. And those patients also need more comprehensive intervention such as psychosocial programs to improve their function. This protocol is to conduct a study in several sites of China to investigate the effectiveness of comprehensive intervention combining sequenced atypical antipsychotic therapy and intensive psychosocial intervention for first-episode schizophrenic patients. In addition, this protocol also aims at collecting such information as molecular genetics, neurochemical test, neucognitive performance and neuroimaging for outcome analysis.

Purpose of this non-interventional study (NIS) is to assess the effect of the participation in an integrated care program on treatment outcomes in patients treated with Seroquel for schizophrenia.

Quetiapine fumarate is indicated for the treatment of patients with schizophrenia in China. Lots of clinical experience and evidence has demonstrated its efficacy and tolerability for the patient population. Some evidence showed that quetiapine fumarate could control aggression and agitation within 1 week, which is appropriate for the acute treatment of patients with schizophrenia. PANSS and MOAS are the common measurements for the efficacy of psychotic symptoms controlling in the clinical trials. Generally, 2 weeks are the appropriate timeframe for the evaluation of clinical effect of agitation and aggression symptoms controlling. In adult patients with schizophrenia, quetiapine fumarate is licensed to maximal dose of 750mg/day. The target dose of quetiapine fumarate recommended in the manufacturer's prescribing information is 300-450 mg/day in China, though similar efficacy for quetiapine fumarate (600 mg/day), olanzapine (15 mg/day) and Risperidone (5 mg/day) was reported in a small, randomised, rater-blinded trial. Because of the low incidence of EPS, the limitation potential for weight gain and prolactin elevation, quetiapine fumarate should be well tolerated in this sensitive patient population with higher dose (600mg/day-750mg/day) (Peuskens 2004). The aim of the present study is to evaluate the efficacy and safety of quetiapine fumarate with daily dose 600-750mg/day in improving agitation and aggression for the treatment of Chinese acute schizophrenic patients hospitalised for acute phase over a treatment period of 2 weeks