Trial Outcomes & Findings for Ziprasidone in Pediatric Bipolar Disorder (NCT NCT00622739)

NCT ID: NCT00622739

Last Updated: 2019-10-22

Results Overview

The Young Mania Rating Scale (YMRS) is a measure of the severity of manic symptoms. The scores on the scale range from 0-56. A score of more than or equal to 14 was the cut off for inclusion into this study. A higher score denotes increased severity of manic symptoms.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

28 participants

Primary outcome timeframe

6 weeks of treatment

Results posted on

2019-10-22

Participant Flow

Participant milestones

Participant milestones
Measure
Ziprasidone Rapid Dose Group
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Overall Study
STARTED
13
15
Overall Study
COMPLETED
11
9
Overall Study
NOT COMPLETED
2
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Ziprasidone Rapid Dose Group
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Overall Study
Physician Decision
1
0
Overall Study
Adverse Event
1
2
Overall Study
Lack of Efficacy
0
2
Overall Study
Withdrawal by Subject
0
1
Overall Study
Lost to Follow-up
0
1

Baseline Characteristics

Ziprasidone in Pediatric Bipolar Disorder

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Total
n=28 Participants
Total of all reporting groups
Age, Customized
13.53 years
STANDARD_DEVIATION 2.62 • n=5 Participants
13.38 years
STANDARD_DEVIATION 2.50 • n=7 Participants
13.4 years
STANDARD_DEVIATION 2.5 • n=5 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
6 Participants
n=7 Participants
12 Participants
n=5 Participants
Sex: Female, Male
Male
7 Participants
n=5 Participants
9 Participants
n=7 Participants
16 Participants
n=5 Participants
Region of Enrollment
United States
13 participants
n=5 Participants
15 participants
n=7 Participants
28 participants
n=5 Participants

PRIMARY outcome

Timeframe: 6 weeks of treatment

The Young Mania Rating Scale (YMRS) is a measure of the severity of manic symptoms. The scores on the scale range from 0-56. A score of more than or equal to 14 was the cut off for inclusion into this study. A higher score denotes increased severity of manic symptoms.

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Young Mania Rating Scale (YMRS)
12.70 units on a scale
Standard Error 1.41
12.57 units on a scale
Standard Error 1.32

SECONDARY outcome

Timeframe: 6 weeks of treatment

The CDRS-R is a 17 item clinician-rated instrument used to measure severity of depressive symptoms in youth (ages 6-18). Each item is rated on a 1 to 5 or 1 to 7 point scale, with a 1 describing absence of the given symptom. The CDRS-R yields a total score from 17 to 113 with a score of 40 or greater considered to symptomatic of depression. Scores of 35-40 indicate mild depression, 29-34 is borderline and \<28 is no depression.

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Children's Depression Rating Scale
32.56 score on a scale
Standard Error 1.44
29.22 score on a scale
Standard Error 1.34

SECONDARY outcome

Timeframe: 6 weeks of treatment

The CGI-S assesses clinical severity. The CGI-S is a seven point scale where 1 is the minimum value and 7 is the maximum value. Lower scores mean a better outcome. The CGI-Severity scale scores are: 1=normal, not at all ill; 2=borderline mentally ill; 3=mildly ill; 4=moderately ill; 5=markedly ill; 6=severely ill; 7=among the most extremely ill patients.

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Clinical Global Impressions-Severity (CGI-S) Scale
3.63 units on a scale
Standard Error 0.19
3.36 units on a scale
Standard Error 0.18

SECONDARY outcome

Timeframe: 6 weeks of treatment

The Systematic Assessment for Treatment of Emergent Events (SAFTEE) is one of the first comprehensive Adverse effects-elicitation instruments developed specifically for use in psychiatric clinical trials. The SAFTEE is a standardized method, which increases consistency of Adverse Effects data, both within and across clinical trials.It allows ratings of five levels of severity and collects information about the onset, duration, pattern, judgement of attribution of cause, and action taken by the clinician. Suggested probe questions are also provided, which the clinician can use to elicit detailed information about the AE. Furthermore, the SAFTEE requires the clinician to determine a time interval of inquiry to be used in the trial. Adverse Effects are graded as None=0, Mild=1, Moderate=2, Severe=3.

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
SAFTEE (Side Effects Rating Scale)
0.32 units on a scale
Standard Error 0.09
0.46 units on a scale
Standard Error 0.08

SECONDARY outcome

Timeframe: 6 weeks of treatment

AIMS is a 12-item instrument assessing abnormal involuntary movements associated with antipsychotic drugs, such as tardive dystonia and chronic akathisia, as well as 'spontaneous' motor disturbance related to the illness itself. Scoring the AIMS consists of rating the severity of movement in three main anatomic areas (facial/oral, extremities, and trunk), based on a five-point scale (0=none, 4=severe).

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
AIMS (Abnormal Involuntary Movement Scale)
0.20 units on a scale
Standard Error 0.15
0.32 units on a scale
Standard Error 0.14

SECONDARY outcome

Timeframe: 6 weeks of treatment

The BARS measures drug-induced akathisia occurring specifically with use of neuroleptic agents. It is a four-item fully anchored scale. Three items (objective akathisia, subjective awareness of restlessness, and subjective distress related to restlessness) are rated on a 4-point scale (0= normal and 9= most severe) and, the global clinical assessment of akathisia uses a 5-point scale (0= normal and 4= most severe). Total scores ranged from 0-13 with higher scores reflecting more akathisia.

Outcome measures

Outcome measures
Measure
Ziprasidone Rapid Dose Group
n=13 Participants
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 Participants
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Barnes Akathisia Rating Scale (BARS)
0.11 units on a scale
Standard Error 0.05
0.06 units on a scale
Standard Error 0.04

Adverse Events

Ziprasidone Rapid Dose Group

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

Ziprasidone Slow Dose Group

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

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Ziprasidone Rapid Dose Group
n=13 participants at risk
Rapid Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20 mg to a maximum of 160 mg. Arm 1 will have the dose of Ziprasidone titrated at a rate of 20 mg every 2 days, reaching the maximum dose in 14 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Ziprasidone Slow Dose Group
n=15 participants at risk
Slow Dose Titration Group Ziprasidone: Subjects will be treated openly with Ziprasidone for 6 weeks. Dose will be titrated from 20mg to a maximum of 160mg. Arm 2 will have the dose of Ziprasidone titrated at a rate of 20mg every 3-4 days, reaching the maximum dose in 25 days. Final dose of Ziprasidone will be determined by symptoms reduction and the presence or absence of side effects.
Psychiatric disorders
Dystonic Reaction
7.7%
1/13 • Number of events 1
0.00%
0/15
Psychiatric disorders
worsening of mood and inadequate response to medicaiton
0.00%
0/13
13.3%
2/15 • Number of events 2

Additional Information

Kirti Saxena

Baylor College of Medicine

Phone: 832-822-4065

Results disclosure agreements

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