Trial Outcomes & Findings for The Effects of Atomoxetine on Cognition and Brain Function Based on Catechol-O-methyltransferase(COMT) Genotype (NCT NCT00548327)

NCT ID: NCT00548327

Last Updated: 2013-06-14

Results Overview

Main outcome measures were BOLD fMRI response (activation) while performing a prefrontal cortex-dependent task such as N-Back Working Memory with increasing levels of task difficulty. It was expected to have a greater level of activation in BOLD fMRI in schizophrenic patients with respect to normal volunteers, and a greater activation in individuals (either normal volunteers or patients) who share the val/val genotype with respect to the met/met genotype. Based on prior fMRI studies and on power analysis of neuropsychological variables, at least 28 and 26 subjects are respectively needed to achieve significant power in functional neuroimaging and neuropsychological studies.These sizes provide an 80% power to observe significant differences between drug conditions at the 0.05 level.

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

11 participants

Primary outcome timeframe

2 hours after the first or the second dose of Atomoxetine or placebo on 14th day

Results posted on

2013-06-14

Participant Flow

Normal volunteers or patients with schizophrenia will be initially recruited from among individuals who have volunteered for previous genetic studies and for whom genetic data is already available. Power calculations set target accrual at 30 participants per genotype for 3 COMT genotypes per cohort (i.e., 90 patients and 90 healthy volunteers).

Subjects need to satisfy the inclusion/exclusion criteria for the genetic studies protocol before participating. Normal volunteers will be enrolled as outpatients and patients as inpatients. Females do both arms during the same phase of the menstrual cycle. Patients with Schizophrenia are stabilized for at least 6 weeks before the protocol.

Participant milestones

Participant milestones
Measure
Healthy Participants
This is a double-blind, placebo-control, cross-over study of Atomoxetine in healthy volunteers. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Patients With Schizophrenia
This is a double-blind, placebo-control, cross-over study of Atomoxetine in patients with schizophrenia. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Overall Study
STARTED
6
5
Overall Study
COMPLETED
6
4
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Healthy Participants
This is a double-blind, placebo-control, cross-over study of Atomoxetine in healthy volunteers. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Patients With Schizophrenia
This is a double-blind, placebo-control, cross-over study of Atomoxetine in patients with schizophrenia. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Overall Study
Adverse Event
0
1

Baseline Characteristics

The Effects of Atomoxetine on Cognition and Brain Function Based on Catechol-O-methyltransferase(COMT) Genotype

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Healthy Participants
n=6 Participants
This is a double-blind, placebo-control, cross-over study of Atomoxetine in healthy volunteers. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Patients With Schizophrenia
n=5 Participants
This is a double-blind, placebo-control, cross-over study of Atomoxetine in patients with schizophrenia. It includes 3 genotypes, the VAL/VAL, VAL/MET and MET/MET. Subjects are 2 weeks on placebo, 2 weeks on active compound and one week wash-out period between arms. Amoxetine schedule: 25 mg Day 1 (or Day 22), 40 mg Day 2-3 (or Days 23-24), 60 mg Days 4-5 (or Days 25-26), 80 mg Days 6-14 (or Days 27-35). Placebo schedule: Atomoxetine 25 mg Placebo Day 1 (or Day 22), Atomoxetine 40 mg Placebo Day 2-3 (or Days 23-24), Atomoxetine 60 mg Placebo Days 4-5 (or Days 25-26), Atomoxetine 80 mg Placebo Days 6-14 (or Days 27-35).
Total
n=11 Participants
Total of all reporting groups
Age, Customized
<=18 years
0 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
Age, Customized
Between 18 and 45 years
6 participants
n=5 Participants
5 participants
n=7 Participants
11 participants
n=5 Participants
Age, Customized
>=45 years
0 participants
n=5 Participants
0 participants
n=7 Participants
0 participants
n=5 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Sex: Female, Male
Male
5 Participants
n=5 Participants
5 Participants
n=7 Participants
10 Participants
n=5 Participants
Region of Enrollment
United States
6 participants
n=5 Participants
5 participants
n=7 Participants
11 participants
n=5 Participants

PRIMARY outcome

Timeframe: 2 hours after the first or the second dose of Atomoxetine or placebo on 14th day

Population: Data were not collected for analysis because the study was terminated before target accrual

Main outcome measures were BOLD fMRI response (activation) while performing a prefrontal cortex-dependent task such as N-Back Working Memory with increasing levels of task difficulty. It was expected to have a greater level of activation in BOLD fMRI in schizophrenic patients with respect to normal volunteers, and a greater activation in individuals (either normal volunteers or patients) who share the val/val genotype with respect to the met/met genotype. Based on prior fMRI studies and on power analysis of neuropsychological variables, at least 28 and 26 subjects are respectively needed to achieve significant power in functional neuroimaging and neuropsychological studies.These sizes provide an 80% power to observe significant differences between drug conditions at the 0.05 level.

Outcome measures

Outcome data not reported

PRIMARY outcome

Timeframe: 2 hours after the first or the second dose of Atomoxetine or placebo on 14th day

Population: Data were not collected for analysis because the study was terminated before target accrual

Neuropsychological testing consists of a battery of 10-12 individual tests to measure cognitive function. We expect both a drug effect and a genotype effect on neuropsychological tasks that measure dorsolateral prefrontal cortex (DLPFC) executive function, mostly in individuals who share the val/val genotype with respect to the met/met genotype.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: At 14th and 35th days

Population: Data were not collected for analysis because the study was terminated before target accrual

The Positive and Negative Syndrome Scale (PANSS) is a 7-point rating scale with (1) indicating the absence of a symptom or behavior and (7) indicating the most severe symptom. The PANSS includes three scales(Positive and Negative Syndromes and General Psychopathology)and five clusters (Anergia, Thought Disturbance, Activation, Paranoid/Belligerence and Depression.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: At 14th and 35th days

Population: Data were not collected for analysis because the study was terminated before target accrual

The Profile of Mood States is an instrument that provides a rapid method of assessing transient, fluctuating mood states. The POMS consists of 65 adjectives rated by subjects on a 5-point scale and six factors that derive from this scale are: 1)tension-anxiety, 2)depression-dejection, 3)anger-hostility, 4)fatigue-inertia, 5)vigor-activity and 6)Confusion-bewilderment.

Outcome measures

Outcome data not reported

SECONDARY outcome

Timeframe: At 14th and 35th days

Population: Data were not collected for analysis because the study was terminated before target accrual

The Hamilton Anxiety Rating Scale is a psychological questionnaire to rate the severity of anxiety.It contains 14 symptom-oriented questions.Each of these symptoms is given a severity rating, from not present(scored as 0)to very severe(scored as 4)

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: before and 3 hours after dosing on the 14th day receiving Atomoxetine

Population: Data were not collected for analysis because the study was terminated before target accrual

Blood for drug plasma levels is obtained before and 3 hours after dosing on the 14th day receiving Atomoxetine.

Outcome measures

Outcome data not reported

Adverse Events

Atomoxetine-Patient

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Placebo-Patient

Serious events: 1 serious events
Other events: 2 other events
Deaths: 0 deaths

Atomoxetine-Healthy Volunteer

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Placebo-Healthy Volunteer

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Atomoxetine-Patient
n=5 participants at risk
Placebo-Patient
n=5 participants at risk
Atomoxetine-Healthy Volunteer
n=6 participants at risk
Placebo-Healthy Volunteer
n=6 participants at risk
Psychiatric disorders
Psychosis
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.

Other adverse events

Other adverse events
Measure
Atomoxetine-Patient
n=5 participants at risk
Placebo-Patient
n=5 participants at risk
Atomoxetine-Healthy Volunteer
n=6 participants at risk
Placebo-Healthy Volunteer
n=6 participants at risk
Gastrointestinal disorders
Loss of Appetite
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
33.3%
2/6 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Cardiac disorders
Palpitations
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Gastrointestinal disorders
Nausea
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Psychiatric disorders
Difficulty sleeping
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Gastrointestinal disorders
Dry Mouth
40.0%
2/5 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
40.0%
2/5 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
66.7%
4/6 • Number of events 4 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Gastrointestinal disorders
Constipation
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
40.0%
2/5 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Psychiatric disorders
Fatigue
40.0%
2/5 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
40.0%
2/5 • Number of events 2 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
50.0%
3/6 • Number of events 3 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Reproductive system and breast disorders
Sexual dysfuntion
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Renal and urinary disorders
Urinary difficulties
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Skin and subcutaneous tissue disorders
Sweating
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Nervous system disorders
Dizziness
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Nervous system disorders
Restlessness
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Gastrointestinal disorders
Heartburn
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
20.0%
1/5 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
General disorders
Chills
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Skin and subcutaneous tissue disorders
Itching
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
Psychiatric disorders
unusual thoughts
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/5 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
16.7%
1/6 • Number of events 1 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.
0.00%
0/6 • Two years, from 2008 to 2011.
Adverse events are collected during the arm or at the end of each arm.

Additional Information

Jose A. Apud MD, PhD

Clinical Brain Disoders Branch-National Institute of Mental Health (NIMH)-National Institute of Health (NIH)

Phone: 301 5946561

Results disclosure agreements

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