Ziprasidone Switching in Response to Adherence and Psychotropic-Related Weight Gain Concerns Among Patients With Bipolar Disorder (Zip Ad)
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Purpose
Psychotropic-related weight gain is a common concern among patients with bipolar disorder (BD). This concern affects an individual's satisfaction with treatment and may lead to reduced adherence and illness relapse. Patient-focused care is attentive to patient concerns while at the same time utilizing evidence-based treatments. Ziprasidone is currently FDA approved for the maintenance treatment of BD. Ziprasidone may be associated with less weight gain compared to some alternative BD maintenance treatments. The proposed project will evaluate how switching to ziprasidone may affect patient adherence, drug attitudes, satisfaction with care and clinical outcomes (psychiatric symptoms, functional status, weight) among BD patients concerned with weight gain.
| Condition | Intervention | Phase |
|---|---|---|
|
Medication Adherence Bipolar Disorder |
Drug: ziprasidone |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Ziprasidone Switching in Response to Adherence and Psychotropic-Related Weight Gain Concerns Among Patients With Bipolar Disorder |
- Treatment non-adherence percentage as measured by the Tablet Routines Questionnaire (TRQ) [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-100%
- Treatment adherence score as measured by the Morisky Rating Scale [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-4
- Attitude toward medication score as measured by the Drug Attitude Inventory [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-10
- Global psychopathology score as measured by Clinical Global Impressions [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 1-7
- Social and Occupational Functioning Scale [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-100
- Montgomery Asberg Depression Rating Scale [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-60
- Young Mania Rating Scale [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 0-60
- body weight [ Time Frame: Week 16 ] [ Designated as safety issue: Yes ]
- Heart Rate [ Time Frame: Week 16 ] [ Designated as safety issue: Yes ]
- Laboratory testing [ Time Frame: Week 12 ] [ Designated as safety issue: Yes ]baseline electrolytes, renal function, thyroid function, liver function tests, lipid profile and CBC with differential, B12/folate
- 12-lead EKG [ Time Frame: Week 12 ] [ Designated as safety issue: Yes ]
- Quality of life score as measured by 12-item Short Form Health Survey [ Time Frame: Week 16 ] [ Designated as safety issue: No ]Scale Range: 1-99th percentile score
- Blood Pressure [ Time Frame: Week 16 ] [ Designated as safety issue: Yes ]
- Height [ Time Frame: Week 1 ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 30 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | August 2012 |
| Estimated Primary Completion Date: | August 2012 (Final data collection date for primary outcome measure) |
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Drug: ziprasidone
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Diagnosis of Type I or II BD for at least 6 months (confirmed with MINI)
- On maintenance evidence-based treatment for BD (lithium, antipsychotic, anticonvulsant)
- Have weight gain concerns that individual believes are related to BD medication treatment
- Sub-optimal adherence as measured by the Tablet Routines Questionnaire (TRQ) and which the patient feels is related to weight gain concerns. TRQ threshold will be defined as missing an average of 20% or more of all prescribed BD treatment in the last week or month or missing 20% or more of the "offending agent" in the last week or last month. This is consistent with methodologies in PIs previous BD adherence studies
Exclusion Criteria:
- Known resistance or intolerance to ziprasidone
- Medical contraindication to ziprasidone
- Individuals on ziprasidone immediately prior to study enrollment
- Prior or current treatment with clozapine
- Diagnosis of eating disorder
- Individuals whose sub-optimal adherence is related to inability to pay for BD medication treatment or inability to arrange transportation to BD treatment clinical visits
- Concurrent medical condition or psychiatric illness, which in the opinion of the research psychiatrist, would interfere with the patient's ability to participate in the trial
- Current substance dependence
- High risk of harm to self or others
- Female who is currently pregnant or breastfeeding
Contacts and Locations| United States, Ohio | |
| University Hospitals Case Medical Center | |
| Cleveland, Ohio, United States, 44106 | |
| Principal Investigator: | Martha Sajatovic, M.D. | Case Western Reserve University School of Medicine |
More Information
No publications provided
| Responsible Party: | Martha Sajatovic, Professor of Psychiatry, University Hospitals of Cleveland |
| ClinicalTrials.gov Identifier: | NCT01293825 History of Changes |
| Other Study ID Numbers: | Pfizer IIR-WS883414 |
| Study First Received: | February 10, 2011 |
| Last Updated: | May 1, 2012 |
| Health Authority: | United States: Food and Drug Administration United States: Institutional Review Board |
Additional relevant MeSH terms:
|
Bipolar Disorder Weight Gain Affective Disorders, Psychotic Mood Disorders Mental Disorders Body Weight Changes Body Weight Signs and Symptoms Ziprasidone Psychotropic Drugs Central Nervous System Agents Therapeutic Uses |
Pharmacologic Actions Serotonin Antagonists Serotonin Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs Antipsychotic Agents Tranquilizing Agents Central Nervous System Depressants Dopamine Antagonists Dopamine Agents |
ClinicalTrials.gov processed this record on May 23, 2013