Efficacy and Safety Study of Clozapine Augmented by Atomoxetine Versus Clozapine Augmented by Placebo in Patients With Chronic Resistant Schizophrenia

NCT00216281 | Terminated Phase 3

• 1 other identifier: 0501-47
• Study Type: interventional
• Target: 126
• Locations: 1 country
• Sites: 1

Brief Summary

This is a randomized, placebo-controlled study to assess the efficacy and safety of ATX augmentation of CLZ as a treatment for the cognitive symptoms of schizophrenia. A total sample size of 126 subjects diagnosed with schizophrenia and being treated with the antipsychotic clozapine will undergo genotyping. These subjects will have an initial assessment at four weeks and regular follow-up assessments for a total period of 52 weeks. These subjects will be randomized to continued treatment with CLZ and augmentation with ATX or Placebo.

Conditions

Schizophrenia

Keywords

Schizophrenia; Clozapine; Atomoxetine

Outcome Measures

Primary Outcomes (1)

• Impact of treatment will be based on clinical examination, laboratory values, and rating scales including, PANSS, CGI, AIMS, BAS, SAS, cognitive measures, NOSIE.

  Via rating scales and cognitive measures, effects of CLZ and ATZ on congitive function will be assessed. A total of 126 suybjets diagnosed with Schizophrenia will be recruited, consented, and treated with CLZ and ATZ. They will undergo genetic testing for 31 mutations of CYP2D6 including gene duplication and deletion as well as, two mutations in CYP2C19.

  375 days

Secondary Outcomes (8)

• Concentrations

  week 1 and week 4

• blood cell counts

  week 1 and week 4

• adverse events

  day one forward

• symptom measure

  screen, day 1 and all f/u visits

• social cognition

  screening, day 1 and f/u visits

Study Arms (2)

clozapine with AZT added

ACTIVE COMPARATOR

Clozapine augmented with Atomoxitine up to 40mg

Drug: Clozapine augmented with atomoxetine up to 40 mg or placebo

placebo

PLACEBO COMPARATOR

Subjects will have a placebo pill added to their clozapine regimen.

Drug: Clozapine augmented with atomoxetine up to 40 mg or placebo

Interventions

Clozapine augmented with atomoxetine up to 40 mg or placebo DRUG

clozapine with AZT added; placebo

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Diagnosis of Schizophrenia that meets the diagnostic criteria as defined in the Diagnostic and Statistical Manual of Mental Disorders (4th edition, text revision) (DSM-IV-TR), APA 2000).
• Adult (18-65) males or females with a confirmed primary diagnosis of schizophrenia.
• Stable symptoms as determined by a score of 70 or less on the PANSS.
• Women of child bearing potential must be using a medically accepted means of contraception.
• Adequate cognitive function (IQ \> 65) as assessed by the WRAT3, with a level of understanding sufficient to perform all tests and examinations required by the protocol.
• Considered reliable.
• Stable on clozapine treatment. Criteria for stability defined as follows:
• Patients should have been taking oral clozapine daily for the last 4 weeks (with no change in clozapine dose in the 4 weeks prior to screening).
• Patients must not require chronic add-ons or have taken "as needed" antipsychotic or antidepressant medications in the last four weeks to control agitation, behavioral disturbance, or primary psychiatric symptomatology.
• There must have been no significant change in the level of care required, caused by worsening of schizophrenia in the last four weeks. For example any escalation from lesser to greater intensity of treatment or ER visits.
• Patients must not be taking any additional psychotropic medications including health food supplements judged by the investigator to be likely to have central nervous system activity (for example, St. John's Wort, ginkgo biloba leaf, melatonin).
• Patients must not have received a depot antipsychotic within the past 8 weeks days.
• Each patient must be judged competent and able to understand the nature of the study and must sign an informed consent document prior to participation in the study.
• Patients must be able to swallow medications.

You may not qualify if:

• Clinically significant organic disease that, in the opinion of the investigator, would put the patient at significant risk from study procedures or interfere with data interpretability. This includes hepatic (specifically any degree of jaundice), renal, gastroenterologic, respiratory, cardiovascular (including ischemic heart disease), endocrinologic, neurologic, or immunologic conditions.
• Potentially serious or unstable medical condition that is likely to require excluded medications or other significant treatment during the course of this treatment.
• Patients who have not tolerated atomoxetine in the past or have history of clinically significant adverse effect(s) during prior treatment with atomoxetine.
• Patients who have not tolerated oral CLZ in the past or experienced significant adverse effect(s) in the past.
• History of non-response to clozapine (treatment refractory) defined as unambiguous lack of improvement despite contiguous adequate trial of at least 14 weeks of treatment.
• Clozapine blood levels outside the optimum CLZ plasma levels of 350 to 400 ng/ml.
• Women who are pregnant, breastfeeding, or refuse to use adequate birth control.
• Significant risk of suicidal behavior or pose an imminent significant threat to others, at the time of screening.
• History of alcohol or drug dependence (except nicotine and caffeine) that meets DSM IV criteria, within the past six months or have a history of drug or alcohol abuse within the past 30 days. Patients who have history of cannabis use for recreational purposes may be enrolled if in the opinion of the PI, the drug use pattern is not primarily related to a psychiatric condition or diagnosis.
• Have abnormal blood pressure in the opinion of the investigator.
• Electrocardiograms (ECGs) outside the normal limits.
• Abnormal clinical laboratory test results outside the normal range.
• History of agranulocytosis (absolute neutrophil count \<500 mm3).
• Uncorrected hypothyroidism, hyperthyroidism or abnormal thyroid-stimulating hormone (TSH) concentrations. Patients previously diagnosed with hyperthyroidism or hypothyroidism who have been treated on a stable dose of thyroid supplement for at least 3 months, have medically appropriate TSH concentrations, and who are clinically euthyroid are allowed.
• History of clinically significant head injury.

Sponsors & Collaborators

• Indiana University School of Medicine: lead
• Hoffmann-La Roche: collaborator
• Shekhar, Anantha M.D., Ph.D.: collaborator

Study Sites (1)

LaRue Carter Hospital

Indianapolis, Indiana, 46222, United States

Location

MeSH Terms

Conditions

Schizophrenia

Condition Hierarchy (Ancestors)

Schizophrenia Spectrum and Other Psychotic Disorders; Mental Disorders

Study Officials

• Anantha Shekhar, MD, PhD

  Indiana University School of Medicine

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 19, 2005
• First Posted: September 22, 2005
• Study Start: September 1, 2005
• Primary Completion: October 1, 2006
• Study Completion: September 1, 2008
• Last Updated: March 26, 2013

Record last verified: 2013-03

Locations

US (1)