Polypharmacy in Clozapine-resistant Schizophrenia

NCT ID: NCT00918021

Last Updated: 2010-11-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

30 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-06-30

Study Completion Date

2010-07-31

Brief Summary

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The aim of this randomized, double-blind study is to verify the hypothesis that clozapine monotherapy is as efficient as a combination of clozapine and olanzapine therapy in treatment-resistant schizophrenia.

A third of schizophrenia patients are non -responders to medications used nowadays. These patients are usually treated with clozapine, but a large proportion of patients don't recover sufficiently. Therefore, these patients are treated with combination of two or more drugs to achieve better treatment results. Until now the scientific evidence has been insufficient to assess the utility of polypharmacy.

The aim is to study during 2009 with voluntary patients, if there is any benefit of olanzapine augmentation compared with pure clozapine monotherapy. During the study the patients are not exposed to any additional intervention. The intervention in this study is just to reduce the previously used polypharmacy.

Methods: This study lasts for 24 weeks. Participants (30) are randomized in one of two alternative interventions (A or B) before the study. After 12 weeks the intervention arms cross over (from A to B and from B to A).

Group B: In addition to clozapine, the participants receive their normal dosage of olanzapine (=the same as on the hospital ward) for 12 weeks, next the decreasing dosage of olanzapine for four weeks and subsequently placebo for 8 weeks

Group A: : In addition to clozapine the participants receive the decreasing dosage of olanzapine for four weeks, next placebo for 8 weeks, after that the increasing dosage of olanzapine for four weeks and subsequently the normal dosage of olanzapine for 8 weeks

The response for the medical treatment is assessed by Clinical Global Improvement Scale (CGIS) and Global Assessment of Functioning (GAF) -scale.

The primary outcomes are GAF and modified CGIS during the parallel phase of the study (the first 12 weeks). The second phase (the last 12 weeks) of the cross-over study is used in the secondary analysis. The use of additional medication (such as benzodiazepines) is used as a secondary outcome measure.

Detailed Description

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Conditions

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Schizophrenia Schizoaffective Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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olanzapine (B)

Group B: In addition to clozapine, the participants receive their normal dosage of olanzapine (=the same as on the hospital ward) for 12 weeks, next the decreasing dosage of olanzapine for four weeks and subsequently placebo for 8 weeks.

Group Type ACTIVE_COMPARATOR

olanzapine

Intervention Type DRUG

normal dosage of olanzapine (the same dosage as on hospital ward)

placebo (A)

Group A: : In addition to clozapine the participants receive the decreasing dosage of olanzapine for four weeks, next placebo for 8 weeks, after that the increasing dosage of olanzapine for four weeks and subsequently the normal dosage of olanzapine for 8 weeks.

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

placebo

Interventions

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olanzapine

normal dosage of olanzapine (the same dosage as on hospital ward)

Intervention Type DRUG

placebo

placebo

Intervention Type DRUG

Other Intervention Names

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Solazin

Eligibility Criteria

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Inclusion Criteria

* age ≥18 years, (adult), legally competent
* the patient is able to understand the purpose of the study and is eligible to sign the written informed consent form.
* insufficient response to the valid clozapine-olanzapine -polypharmacy
* psychotropic medication has been constant (unchangeable) during the past 2 months

Exclusion Criteria

* Pregnancy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Niuvanniemi Hospital

OTHER

Sponsor Role lead

Responsible Party

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Jari Tiihonen, Professor and Chairman, Niuvanniemi Hospital

Principal Investigators

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Jari Tiihonen, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Niuvanniemi Hospital

Locations

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Niuvanniemi Hospital

Kuopio, , Finland

Site Status

Countries

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Finland

Other Identifiers

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0911885

Identifier Type: -

Identifier Source: secondary_id

2009-011307-22

Identifier Type: -

Identifier Source: org_study_id