Identification and Treatment Response Prediction of Antipsychotic-Related Metabolic Syndrome
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Purpose
The investigators developed an easy identification model to identify metabolic syndrome in patients with schizophrenia or schizoaffective disorder who received treatment of clozapine, olanzapine, or risperidone. The accuracy of the investigators' models showed well. In the study, the investigators aim to (1) to examine whether the developed identification models can be generalized to patients taking other antipsychotics or patients with other diagnoses; (2) to develop an easy risk score and validate it; (3) to switch antipsychotics to amisulpride or aripiprazole for those with metabolic syndrome, and compare the changes of metabolic parameters including adiponectin, and analyze their association with genetic variants, demography, and clinical variables; (4) to establish models using artificial neural network and statistic method to predict metabolic response after a switch to amisulpride or aripiprazole; (5) to investigate the effect of antipsychotics on adiponectin gene expression and secretion during the differentiation process of 3T3L1 adipocytes.
| Condition | Intervention |
|---|---|
|
Metabolic Syndrome X |
Drug: amisulpride Drug: aripiprazole |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Single Blind (Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Easy Identification, Treatment Response Prediction, and Molecular Mechanism Exploration of Antipsychotic-related Metabolic Syndrome |
- Metabolic profile [ Time Frame: half/one year ] [ Designated as safety issue: Yes ]
- Clinical efficacy [ Time Frame: half/one year ] [ Designated as safety issue: No ]
| Enrollment: | 132 |
| Study Start Date: | November 2009 |
| Study Completion Date: | October 2012 |
| Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Amisulpride
A slow plateau cross-titration method was used to switch original antipsychotics to Amisulpride.
|
Drug: amisulpride
Amisulpride dosage was increased from 200 up to a maximum of 1000 mg/day and the dosage of their previous antipsychotics can be tapered gradually under stable clinical condition.
Other Name: Solian
|
|
Experimental: Aripiprazole
A slow plateau cross-titration method was used to switch original antipsychotics to Aripiprazole.
|
Drug: aripiprazole
Aripiprazole dosage was increased from 5-7.5 up to a maximum of 30 mg/day and the dosage of their previous antipsychotics can be tapered gradually under stable clinical condition.
Other Name: Abilify
|
Eligibility| Ages Eligible for Study: | 20 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Stage I for identification of metabolic syndrome:
Inclusion Criteria:
- A diagnosis of schizophrenia, schizoaffective disorder, delusional disorder, mood disorders, or anxiety disorders based on DSM-IV-TR criteria.
- Age at least 20 years old.
- The current antipsychotic drugs have been used for at least 3 months before evaluation.
- Psychiatrically stable with Clinical Global Impression of Severity scale (CGI-S) not greater than 5
Exclusion Criteria:
- Severe uncontrolled medical illnesses, including cardiovascular, hepatic, renal and metabolic diseases (eg. cancer, poor-control hypertension, diabetes mellitus, and other metabolic diseases).
- Organic mental or neurological disorder, substance abuse or dependence (alcohol, amphetamine, heroin).
- Pregnant or breast-feeding women.
- Patients from Yuli Veterans Hospital, who attended our previous study of identification model.
Stage II for switch response:
Inclusion Criteria:
- The same as Stage I criteria.
- Fulfill the metabolic syndrome criteria.
Exclusion Criteria:
- The same as Stage I criteria except the 4th item.
- Treated with depot form of antipsychotics.
Contacts and Locations| Taiwan | |
| Yu-Li Veterans Hospital | |
| Yu-Li, Hualien County, Taiwan, 981 | |
| Yu-Li Hospital | |
| Yu-Li, Hualien County, Taiwan, 981 | |
| National Taiwan University Hospital | |
| Taipei, Taiwan, 10002 | |
| Principal Investigator: | Chao-Cheng Lin, M.D.,Ph.D. | National Taiwan University Hospital |
More Information
No publications provided
| Responsible Party: | National Taiwan University Hospital |
| ClinicalTrials.gov Identifier: | NCT00956189 History of Changes |
| Other Study ID Numbers: | 200812110M |
| Study First Received: | August 10, 2009 |
| Last Updated: | January 2, 2013 |
| Health Authority: | Taiwan: Department of Health |
Keywords provided by National Taiwan University Hospital:
|
Antipsychotic Agents Metabolic Syndrome X Identification Prediction |
Additional relevant MeSH terms:
|
Metabolic Syndrome X Insulin Resistance Hyperinsulinism Glucose Metabolism Disorders Metabolic Diseases Antipsychotic Agents Sultopride Aripiprazole Tranquilizing Agents Central Nervous System Depressants |
Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Psychotropic Drugs Dopamine Antagonists Dopamine Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 18, 2013