Switching Medication to Treat Schizophrenia

NCT ID: NCT00044655

Last Updated: 2016-04-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

219 participants

Study Classification

INTERVENTIONAL

Study Start Date

2001-07-31

Study Completion Date

2009-03-31

Brief Summary

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This study will evaluate the effectiveness of switching medications in decreasing schizophrenia symptoms in individuals who are currently taking an antipsychotic medication for the treatment of schizophrenia.

Detailed Description

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Over the past several years, new, "atypical" antipsychotic medications have become available to treat schizophrenia with little information to guide prescribing for relatively stable outpatients.

Participants will be randomly assigned to either continue taking their current medications for schizophrenia, or to switch to a new medication. Participants assigned to switch to a new medication will begin receiving either olanzapine (Zyprexa), risperidone (Risperdal), ziprasidone (Geodon), quetiapine (Seroquel), or aripiprazole (Abilify), depending on what they are currently taking. Participants currently taking a single oral medication will switch to olanzapine, risperidone, ziprasidone, quetiapine, or aripiprazole. Participants currently taking a single conventional injectable will begin taking long-acting injectable risperidone (Risperdal Consta). Participants currently taking two antipsychotic medications will begin taking only one of the medications they are currently using. Participants will stay on their assigned treatment for 6 months, after which time the participant's prescribing psychiatrist will advise the participant on which medication should be used. Study participants are interviewed at study start and at follow-up visits for 1 year.

Conditions

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Schizophrenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Stay on baseline medication prescribed

Participants will continue taking medication prescribed at study entry: 1) either long-acting injectable haloperidol or fluphenazine, OR 2) two antipsychotic medications which might include a combination of any of the following: risperidone, olanzapine, ziprasidone, quetiapine, aripiprazole, or conventional (typical) antipsychotic medications.

Group Type ACTIVE_COMPARATOR

Risperidone

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Olanzapine

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Ziprasidone

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Quetiapine

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Aripiprazole

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Switch per study protocol

Participants will change medications from medication prescribed at study entry, either: 1) long-acting injectable risperidone, OR 2) one of the two antipsychotic medications prescribed at baseline which may include any of the following: risperidone, olanzapine, ziprasidone, quetiapine, aripiprazole, or conventional (typical) antipsychotic medications.

Group Type ACTIVE_COMPARATOR

Risperidone

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Olanzapine

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Ziprasidone

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Quetiapine

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Aripiprazole

Intervention Type DRUG

As prescribed by routine prescriber (not dictated by study protocol)

Interventions

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Risperidone

As prescribed by routine prescriber (not dictated by study protocol)

Intervention Type DRUG

Olanzapine

As prescribed by routine prescriber (not dictated by study protocol)

Intervention Type DRUG

Ziprasidone

As prescribed by routine prescriber (not dictated by study protocol)

Intervention Type DRUG

Quetiapine

As prescribed by routine prescriber (not dictated by study protocol)

Intervention Type DRUG

Aripiprazole

As prescribed by routine prescriber (not dictated by study protocol)

Intervention Type DRUG

Other Intervention Names

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Risperdal, Risperdal Consta Zyprexa Geodon Seroquel Abilify

Eligibility Criteria

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Inclusion Criteria

* SCID diagnosis of schizophrenia or schizoaffective disorder
* Partially remitted outpatients, defined as persons who have received clear symptomatic benefit from antipsychotic medication but remain symptomatic (due to lack of efficacy or inability to tolerate an efficacious dose) or suffer significant side effects
* Treatment with antipsychotic medications for at least 2 months
* Received at least 1 outpatient mental health service every 3 months for the past 6 months

Exclusion Criteria

* Severe symptoms or side effects that indicate the necessity for a medication change
* Currently taking 3 or more antipsychotic medications for ongoing daily administration (PRN medications and mood stabilizers are allowable)
* Treatment with clozapine
* One or more nights spent in a psychiatric hospitalization within the past 3 months
* Received services from a crisis intervention program within the past 3 months
* Require placement in a skilled nursing facility as a result of a physical condition or disability
* Criminal charges pending (once charges clear, the person will be considered)
* Pregnant or breast feeding
* Contraindication to any of the medications to which the patient might be assigned
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Icahn School of Medicine at Mount Sinai

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Susan M. Essock, PhD

Role: STUDY_CHAIR

Columbia University

References

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Covell NH, McEvoy JP, Schooler NR, Stroup TS, Jackson CT, Rojas IA, Essock SM; Schizophrenia Trials Network. Effectiveness of switching from long-acting injectable fluphenazine or haloperidol decanoate to long-acting injectable risperidone microspheres: an open-label, randomized controlled trial. J Clin Psychiatry. 2012 May;73(5):669-75. doi: 10.4088/JCP.11m07074. Epub 2012 Mar 6.

Reference Type RESULT
PMID: 22480442 (View on PubMed)

Essock SM, Schooler NR, Stroup TS, McEvoy JP, Rojas I, Jackson C, Covell NH; Schizophrenia Trials Network. Effectiveness of switching from antipsychotic polypharmacy to monotherapy. Am J Psychiatry. 2011 Jul;168(7):702-8. doi: 10.1176/appi.ajp.2011.10060908. Epub 2011 May 2.

Reference Type RESULT
PMID: 21536693 (View on PubMed)

Other Identifiers

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R01MH059312

Identifier Type: NIH

Identifier Source: secondary_id

View Link

GCO 98-924

Identifier Type: -

Identifier Source: org_study_id

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