Trial Outcomes & Findings for Study of the Effects of Mecamylamine and Varenicline in Schizophrenia (NCT NCT00455650)

NCT ID: NCT00455650

Last Updated: 2017-03-28

Results Overview

The Continuous Performance Test-Identical Pairs, CPT-IP, Version 4.0 was developed and normed for use in people with schizophrenia and normal controls. This task estimates attention by requiring an individual to push a response key when two identical pairs of shapes or numbers are presented in sequence. Stimuli were presented with increasing cognitive load: 2-, 3-, and 4-digit targets. Outcome variables measured included correct hits, hit reaction time (HRT), errors of commission: false alarms and random errors, and the primary outcome, variability, or standard deviation, of hit reaction time, HRT-SD. There is only one outcome measure time point because cognitive outcomes were analyzed using crossover analyses of covariance (ANCOVA) with drug (mecamylamine vs. varenicline vs. placebo) as a within subject factor, diagnosis (schizophrenia vs. control) as a between subject factor, as well as study period and drug administration sequence as between subject crossover design factors.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

89 participants

Primary outcome timeframe

Baseline (week 0), week 1, week 2 and week 3 as one time point (see outcome measure description)

Results posted on

2017-03-28

Participant Flow

Participants were stable, outpatient, non-smokers with schizophrenia on a stable dose of antipsychotic medication for at least 4 wks, from an urban community mental health clinic in Boston. Controls were recruited through media advertisements in the greater Boston area and had no lifetime history of Axis I disorders by SCID

89 participants were enrolled, 71 participants (30 patients, 41 controls) completed at least one medication visit and were included in the analyses. 4 participants (3 with schizophrenia, 1 control) missed one and 5 participants (3 with schizophrenia, 2 controls) missed 2 of the 3 medication visits.

Participant milestones

Participant milestones
Measure
Schizoph: Mecamylamine (Wk1),Varenicline (Wk2), Placebo (Wk3)
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizoph: Placebo (Wk1), Mecamylamine (Wk2), Varenicline (Wk3)
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizoph: Varenicline (Wk1), Placebo (Wk2), Mecamylamine (Wk3)
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Control: Mecamylamine (Wk1),Varenicline (Wk2), Placebo (Wk3)
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Placebo (Wk1), Mecamylamine (Wk2), Varenicline (Wk3)
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Varenicline (Wk1), Placebo (Wk2), Mecamylamine (Wk3)
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Week 1
STARTED
10
10
10
14
14
13
Week 1
COMPLETED
10
10
10
14
14
13
Week 1
NOT COMPLETED
0
0
0
0
0
0
Week 2
STARTED
10
10
10
14
14
13
Week 2
COMPLETED
10
10
10
14
14
13
Week 2
NOT COMPLETED
0
0
0
0
0
0
Week 3
STARTED
10
10
10
14
14
13
Week 3
COMPLETED
10
10
10
14
14
13
Week 3
NOT COMPLETED
0
0
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Study of the Effects of Mecamylamine and Varenicline in Schizophrenia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Schizophrenia
n=30 Participants
Study participants in the schizophrenia group were clinically stable, outpatient, non-smokers with schizophrenia on a stable, clinically determined dose of antipsychotic medication for at least 4 weeks, which were recruited from an urban community mental health clinic in Boston. Diagnoses were confirmed by clinical interview and medical record review
Control
n=41 Participants
Healthy volunteers were recruited through media advertisements in the greater Boston area and had no lifetime history of Axis I disorders by SCID interview and no firstdegree relatives with Axis I disorders by history
Total
n=71 Participants
Total of all reporting groups
Age, Continuous
47 years
STANDARD_DEVIATION 10 • n=5 Participants
37 years
STANDARD_DEVIATION 16 • n=7 Participants
42 years
STANDARD_DEVIATION 13 • n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
23 Participants
n=7 Participants
33 Participants
n=5 Participants
Sex: Female, Male
Male
20 Participants
n=5 Participants
18 Participants
n=7 Participants
38 Participants
n=5 Participants
Race/Ethnicity, Customized
Caucasian
24 participants
n=5 Participants
22 participants
n=7 Participants
46 participants
n=5 Participants
Race/Ethnicity, Customized
African American
5 participants
n=5 Participants
12 participants
n=7 Participants
17 participants
n=5 Participants
Race/Ethnicity, Customized
Asian or Pacific Islander
0 participants
n=5 Participants
4 participants
n=7 Participants
4 participants
n=5 Participants
Race/Ethnicity, Customized
Unknown
1 participants
n=5 Participants
3 participants
n=7 Participants
4 participants
n=5 Participants
Region of Enrollment
United States
30 participants
n=5 Participants
41 participants
n=7 Participants
71 participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline (week 0), week 1, week 2 and week 3 as one time point (see outcome measure description)

The Continuous Performance Test-Identical Pairs, CPT-IP, Version 4.0 was developed and normed for use in people with schizophrenia and normal controls. This task estimates attention by requiring an individual to push a response key when two identical pairs of shapes or numbers are presented in sequence. Stimuli were presented with increasing cognitive load: 2-, 3-, and 4-digit targets. Outcome variables measured included correct hits, hit reaction time (HRT), errors of commission: false alarms and random errors, and the primary outcome, variability, or standard deviation, of hit reaction time, HRT-SD. There is only one outcome measure time point because cognitive outcomes were analyzed using crossover analyses of covariance (ANCOVA) with drug (mecamylamine vs. varenicline vs. placebo) as a within subject factor, diagnosis (schizophrenia vs. control) as a between subject factor, as well as study period and drug administration sequence as between subject crossover design factors.

Outcome measures

Outcome measures
Measure
Schizophrenia: Mecamylamine
n=30 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Varenicline
n=30 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Placebo
n=30 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Control: Mecamylamine
n=41 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Varenicline
n=41 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Placebo
n=41 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Effects of Mecamylamine and Varenicline Compared With Placebo in Schizophrenia and Control Groups on Prolonged Attention as Assessed With the CPT-IP Hit Reaction Time Variability
141.6 ms
Standard Deviation 57.5
120.5 ms
Standard Deviation 58.5
123.1 ms
Standard Deviation 44.9
91.2 ms
Standard Deviation 31.1
83.2 ms
Standard Deviation 30.2
87.8 ms
Standard Deviation 21.7

SECONDARY outcome

Timeframe: Baseline (week 1), week 2, week 3, week 4 analyzed as a single time point

In the 3-card Stroop Task, 3 cards were presented; the 1st contained color names printed in black ink, the 2nd contained colored patches of ink, the 3rd contained color names printed in incongruously colored ink. Participants were asked to read or name as many items as possible in 45 seconds for each condition. Individuals are asked to identify the color of the ink of a word. They may be distracted by the presence of a word that states another color (i.e. the word "blue" written in green ink would require the answer green).The interference score was calculated by dividing the color-word score by the color score. There is only one outcome measure time point because cognitive outcomes were analyzed using crossover analyses of covariance (ANCOVA) with drug (mecamylamine vs varenicline vs pbo) as a within subject factor, diagnosis (schizophrenia vs. control) as a between subject factor as well as study period and drug administration sequence as between subject crossover design factors

Outcome measures

Outcome measures
Measure
Schizophrenia: Mecamylamine
n=30 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Varenicline
n=30 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Placebo
n=30 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Control: Mecamylamine
n=41 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Varenicline
n=41 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Placebo
n=41 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Effects of Mecamylamine and Varenicline Compared With Placebo in Schizophrenia and Control Groups on Cognitive Interference as Assessed by The Three-card Stroop Task
50.2 score
Standard Deviation 6.8
52.8 score
Standard Deviation 8.0
50.3 score
Standard Deviation 8.3
54.4 score
Standard Deviation 10.5
53.3 score
Standard Deviation 9.2
53.5 score
Standard Deviation 8.6

SECONDARY outcome

Timeframe: Baseline (week 1), week 2, week 3, week 4 analyzed as a single time point

The N-back task with 1- and 2-back parametric conditions was used. During the task, a letter was displayed for 1,500 ms every 2 s with a 500 ms isi. Participants were asked to press the "1" key for letters that corresponded to the letter 1 back for the 1-back condition, the "2" key for the 2-back condition, and the "3" key for nontarget letters. Outcome variable presented is hit reaction time There is only one outcome measure time point because this outcome was analyzed using crossover analyses of covariance (ANCOVA) with drug (mecamylamine vs. varenicline vs. placebo) as a within subject factor, diagnosis (schizophrenia vs. control) as a between subject factor, as well as study period and drug administration sequence as between subject crossover design factors.

Outcome measures

Outcome measures
Measure
Schizophrenia: Mecamylamine
n=30 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Varenicline
n=30 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Placebo
n=30 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Control: Mecamylamine
n=41 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Varenicline
n=41 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Placebo
n=41 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Effects of Mecamylamine and Varenicline Compared With Placebo in Schizophrenia and Control Groups on Sustained Attention as Assessed by The N-back Task
909.2 ms
Standard Deviation 250.9
931.2 ms
Standard Deviation 297.9
894.4 ms
Standard Deviation 282.1
864.6 ms
Standard Deviation 253.9
795.8 ms
Standard Deviation 241.7
827.5 ms
Standard Deviation 229.3

SECONDARY outcome

Timeframe: Baseline (week 1), week 2, week 3, week 4 analyzed as a single time point

In the Visual spatial working memory (VSWM), participants were asked to place the cursor where the symbol appeared immediately after its display. For 16 additional trials, participants were asked to identify the symbol location after a 30-second delay. During the delay, participants were distracted by being asked to read aloud words appearing on the screen at 2-second intervals. The outcome of interest in this task were the average distance from the target for immediate and delayed recall There is only one outcome measure time frame because this outcome was analyzed using crossover analyses of covariance (ANCOVA) with drug (mecamylamine vs. varenicline vs. placebo) as a within subject factor, diagnosis (schizophrenia vs. control) as a between subject factor, as well as study period and drug administration sequence as between subject crossover design factors.

Outcome measures

Outcome measures
Measure
Schizophrenia: Mecamylamine
n=30 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Varenicline
n=30 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Schizophrenia: Placebo
n=30 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Control: Mecamylamine
n=41 Participants
Mecamylamine: A single dose of 10 mg of mecamylamine (via two 5 mg capsules) is given at the start of the mecamylamine arm of the study. This is the only administration of mecamylamine given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Varenicline
n=41 Participants
Varenicline: A single dose of 1 mg of varenicline (via two 0.5 mg capsules) is given at the start of the varenicline arm of the study. This is the only administration of varenicline given during the course of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance.
Control: Placebo
n=41 Participants
Placebo: The placebo contains no active medication. The placebo dose is given via two capsules at the start of the placebo arm of the study. Participants' blood pressure and vitals are checked regularly for five hours after drug administration for monitoring and safety assurance. The placebo has no effects that last for any duration of time.
Effects of Mecamylamine and Varenicline Compared With Placebo in Schizophrenia and Control Groups on Working Memory as Assessed by The Visual Spatial Working Memory (VSWM) Task
2.83 Distance (in)
Standard Deviation 0.71
2.72 Distance (in)
Standard Deviation 0.66
2.87 Distance (in)
Standard Deviation 0.76
2.29 Distance (in)
Standard Deviation 0.54
2.28 Distance (in)
Standard Deviation 0.54
2.25 Distance (in)
Standard Deviation 0.53

Adverse Events

Schizophrenia

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

A. Eden Evins, MD, MPH

Massachusetts General Hospital

Phone: 617-643-4679

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place