SMART Design to Compare Antipsychotic Treatments in Treatment-Resistant Schizophrenia

NCT ID: NCT04528095

Last Updated: 2020-08-27

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

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

162 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-31

Study Completion Date

2022-12-31

Brief Summary

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The project intends to take treatment-resistant schizophrenia as the research object and uses sequential multiple assignment randomized trial(SMART) design to define the treatment recommendations of different drug regimen for treatment resistant schizophrenia and to determine the physical enhancement regimen for clozapine-resistant schizophrenia and to explore targeted regulation scheme for ultra-resistant schizophrenia.

Detailed Description

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This trial is a sequential multiple-assignment RCT design of antipsychotic drugs, planning to recruit 162 people with treatment-resistant schizophrenia followed for 12 months. The study includes three treatment phases and a naturalistic follow-up phase. Participants who meet the response criteria remain on that treatment for the duration of 12-month treatment. If the participants fail the treatment or can't tolerant the side effects, the patient moves to the next phase of the study to receive a new treatment.

Conditions

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Treatment-resistant Schizophrenia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Clozapine

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml

Group Type EXPERIMENTAL

Clozapine

Intervention Type DRUG

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Amisulpride 200-800mg/d Gingke biloba 120-360mg/d

Clozapine+Amisulpride

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Amisulpride 200-800mg/d

Group Type EXPERIMENTAL

Clozapine

Intervention Type DRUG

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Amisulpride 200-800mg/d Gingke biloba 120-360mg/d

Clozapine+Gingke biloba

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Gingke biloba 120-360mg/d

Group Type EXPERIMENTAL

Clozapine

Intervention Type DRUG

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Amisulpride 200-800mg/d Gingke biloba 120-360mg/d

MECT

MECT:The treatment lasted for 4 months,16 times in total

Group Type EXPERIMENTAL

MECT

Intervention Type DEVICE

MECT:The treatment lasted for 4 months,16 times in total MST:The treatment lasted for 4 months,16 times in total

MST

MST:The treatment lasted for 4 months,16 times in total

Group Type EXPERIMENTAL

MECT

Intervention Type DEVICE

MECT:The treatment lasted for 4 months,16 times in total MST:The treatment lasted for 4 months,16 times in total

DBS

Two electrode emplacement groups (target nucleus accumbens and hippocampus respectively)

Group Type EXPERIMENTAL

DBS

Intervention Type DEVICE

Two electrode emplacement groups (target nucleus accumbens and hippocampus respectively)

Interventions

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Clozapine

Clozapine 400 \~ 600mg/d or plasma concentration \>350ng/ml Amisulpride 200-800mg/d Gingke biloba 120-360mg/d

Intervention Type DRUG

MECT

MECT:The treatment lasted for 4 months,16 times in total MST:The treatment lasted for 4 months,16 times in total

Intervention Type DEVICE

DBS

Two electrode emplacement groups (target nucleus accumbens and hippocampus respectively)

Intervention Type DEVICE

Other Intervention Names

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Clozapine+Amisulpride Clozapine+Gingke biloba MST

Eligibility Criteria

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Inclusion Criteria

1. meet the DSM-5 diagnostic criteria for schizophrenia,
2. be 18-55 years of age,
3. treatment-resistant schizophrenia:no response to sufficient doses (400-600 mg/ day CPZ equivalent) of at least two antipsychotics in the past 5 years,
4. Informed consent.

Exclusion Criteria

1. Patients with medical or psychiatric comorbidities and those who require concomitant other medications are excluded.
2. Patients with contraindications to even one of the proposed treatment arms are excluded.
3. Patients with risks such as extreme agitation, stupor or suicide are excluded.
4. Female patients with pregnancy or breast-feeding are also excluded.
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Mental Health Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dengtang Liu, MD

Role: STUDY_CHAIR

Shanghai Mental Health Center

Locations

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Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

Central Contacts

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Dengtang Liu, MD

Role: CONTACT

18017311138

Other Identifiers

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TRS-SMART

Identifier Type: -

Identifier Source: org_study_id

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