Treatment of Mania Symptoms With Drug Therapy

NCT ID: NCT00183443

Last Updated: 2018-07-17

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-02-28

Study Completion Date

2010-11-30

Brief Summary

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This study will determine the effectiveness of three different drug therapies in treating the symptoms of mania.

Detailed Description

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Mania is a serious condition characterized by extreme excitement, mental and physical hyperactivity, insomnia, and disconnected thoughts. Symptoms of mania are common in patients with schizophrenia or bipolar disorder. When associated with these conditions, mania reaches psychotic proportions and often includes hallucinations, paranoia, and feelings of omnipotence. Such symptoms may put individuals with mania and those around them at risk for physical harm. Drug therapies that can safely and effectively treat symptoms of mania are needed. This study will compare three drug combinations in their ability to treat symptoms of mania in people with schizophrenia or bipolar I disorder.

This study will comprise a 12-week acute phase and a 14-week continuation phase. While the acute phase is the primary component of this study, the continuation phase will provide extended data on the characteristics and course of responders to the initial treatment combinations. Results from the continuation phase will be reported elsewhere. In the acute phase, participants will be randomly assigned to receive one of three treatments: divalproex-extended release (DV-ER) and lithium, DV-ER and quetiapine, or DV-ER and placebo. Participants will receive their intervention for 12 weeks. Participants will have weekly study visits for the first 4 weeks of the acute phase; biweekly study visits will occur for the following 8 weeks. After the acute phase, participants who have not responded to their drug regimen will complete their participation in the study.

Participants whose symptoms of mania have decreased will be offered enrollment in the 14-week continuation phase, during which time participants will continue the drug regimen they began in the acute phase. Participants will have biweekly study visits in the continuation phase. During each study visit in both phases, participants will be interviewed about their mania symptoms. Mania, depression, quality of life, and overall functioning scales will assess participants at study entry, at the end of the acute phase, and at the end of the continuation phase. Participants over 50 years of age will have an electrocardiogram (EKG) at study entry to determine cardiac function.

Conditions

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Bipolar Disorder Schizophrenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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DVP + placebo

Participants will receive divalproex ER at a therapeutic dose, plus placebo

Group Type PLACEBO_COMPARATOR

Divalproex-extended release (DVP-ER)

Intervention Type DRUG

Divalproex ER will be given in 250 mg or 500 mg tablets. Dosing is once a day, every day, for the duration of study participation, either 12 or 26 weeks.

DVP + Quetiapine

Participants will receive divalproex ER at a therapeutic dose, plus quetiapine up to 800 mg

Group Type ACTIVE_COMPARATOR

Divalproex-extended release (DVP-ER)

Intervention Type DRUG

Divalproex ER will be given in 250 mg or 500 mg tablets. Dosing is once a day, every day, for the duration of study participation, either 12 or 26 weeks.

Quetiapine

Intervention Type DRUG

Quetiapine will be dosed to efficacy, provided in 50 mg, 100 mg, 200 mg, or 300 mg pills.

DVP + Lithium

Participants will receive divalproex ER at a therapeutic dose, plus lithium at a therapeutic blood level

Group Type ACTIVE_COMPARATOR

Divalproex-extended release (DVP-ER)

Intervention Type DRUG

Divalproex ER will be given in 250 mg or 500 mg tablets. Dosing is once a day, every day, for the duration of study participation, either 12 or 26 weeks.

Lithium

Intervention Type DRUG

Extended release lithium will be provided in 300 mg capsules. Participants will be dosed to a therapeutic blood level of lithium from 0.8 to 1.2 mcg/L.

Interventions

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Divalproex-extended release (DVP-ER)

Divalproex ER will be given in 250 mg or 500 mg tablets. Dosing is once a day, every day, for the duration of study participation, either 12 or 26 weeks.

Intervention Type DRUG

Lithium

Extended release lithium will be provided in 300 mg capsules. Participants will be dosed to a therapeutic blood level of lithium from 0.8 to 1.2 mcg/L.

Intervention Type DRUG

Quetiapine

Quetiapine will be dosed to efficacy, provided in 50 mg, 100 mg, 200 mg, or 300 mg pills.

Intervention Type DRUG

Other Intervention Names

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depakote ER Lithobid Seroquel

Eligibility Criteria

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Inclusion Criteria

* Diagnosis of bipolar I disorder or schizophrenia
* Experiencing symptoms of mania at study entry
* Able to speak and understand English
* Willing and able to comply with all study requirements

Exclusion Criteria

* History of partial response or nonresponse to any of the drugs or drug combinations given in this study
* History of intolerance to DVP, DVP-ER, lithium, or quetiapine
* Disorders that would contraindicate the use of DV, DV-ER, lithium, or quetiapine
* Use of antidepressants within 1 month prior to study entry
* Use of fluoxetine within 3 months prior to study entry
* Impaired cardiac function, as evidenced by abnormal EKG in participants 50 or over
* Unstable medical illness within 2 months prior to study entry
* At risk for suicide
* Substance abuse or dependence within 1 month prior to study entry
* Pregnancy, breastfeeding, or plans to become pregnant during the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Palo Alto Veterans Institute for Research

OTHER

Sponsor Role lead

Responsible Party

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Patricia Suppes

Director, Bipolar and Depression Research Program

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Trisha Suppes, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Stanford School of Medicine and VA Palo Alto Health Care System

Locations

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VA Palo Alto Health Care System

Palo Alto, California, United States

Site Status

Countries

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United States

References

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Cosgrove VE, Allende S, Gwizdowski I, Grace Fischer E, Ostacher M, Suppes T. A pilot trial of quetiapine, lithium, or placebo added to divalproex sodium for hypomanic or manic episodes in ambulatory adults with bipolar I disorder. Int J Bipolar Disord. 2022 Mar 2;10(1):7. doi: 10.1186/s40345-022-00252-w.

Reference Type DERIVED
PMID: 35235061 (View on PubMed)

Other Identifiers

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R01MH069801

Identifier Type: NIH

Identifier Source: secondary_id

View Link

DSIR 83-ATSO

Identifier Type: -

Identifier Source: secondary_id

SUP0001AGG/ADO

Identifier Type: -

Identifier Source: org_study_id

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