Effects of Modafinil on Olanzapine Weight Gain

This study has been completed.
Sponsor:
Collaborators:
Eli Lilly and Company
University of North Dakota
Information provided by:
Neuropsychiatric Research Institute, Fargo, North Dakota
ClinicalTrials.gov Identifier:
NCT00636896
First received: March 10, 2008
Last updated: NA
Last verified: March 2008
History: No changes posted

March 10, 2008
March 10, 2008
July 2006
August 2007   (final data collection date for primary outcome measure)
Change in weight [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
Same as current
No Changes Posted
  • Change in Kilocalories consumed [ Time Frame: Over 3 weeks ] [ Designated as safety issue: No ]
  • Change in Epworth sleep scale [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Change in Food Craving Inventory [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Change in delta ghrelin [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Change in delta PYY3-36 [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Change in satiety ratings [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Change in hunger ratings [ Time Frame: 3 weeks ] [ Designated as safety issue: No ]
  • Adverse effect comparison [ Time Frame: 3 weeks ] [ Designated as safety issue: Yes ]
Same as current
Not Provided
Not Provided
 
Effects of Modafinil on Olanzapine Weight Gain
A Comparison of the Effects of Modafinil on Olanzapine Associated Eating Behaviors in Normal Human Subjects

This study is designed as a 3 week, randomized, double blind, placebo controlled, trial. Olanzapine and modafinil will be titrated to 10mg and 200mg respectively. Feeding lab assessments will be conducted at baseline and endpoint. Assessments of hunger/satiety, kilocalories consumed and weight will be obtained. Plasma ghrelin and PYY3-36 levels will be drawn at baseline and endpoint prior to breakfast and two hours post.

Study hypothesis: The modafinil/olanzapine group will gain less weight than the olanzapine/placebo group over three weeks of drug intake.

Atypical antipsychotics have become the drugs of choice in the treatment of schizophrenia as well as acute and maintenance therapy for bipolar disorder. In addition, affective disorders have been found to benefit from these agents (Masan 2004). These disorders represent chronic conditions that require extended treatment for years if not lifetimes. In light of the ever widening use of the atypicals, attention must now be focused on adverse reactions that may limit compliance with these agents. Weight gain and sedation have proven to be associated with many atypicals (Allison et al. 1999; Wirshing et al. 1999) including clozapine, olanzapine, risperidone and quetiapine. These side effects can reduce compliance and have detrimental effects on patient's health over long term treatment.

In our previous study, olanzapine and risperidone were demonstrated to affect eating behaviors and weight/BMI compared to placebo in a 2 week paradigm in normal healthy human subjects. Behaviors affected included appetite, reported calories consumed per day, and observed calories consumed in a feeding laboratory. No effects were seen on resting energy expenditure corrected for lean body weight. Also, sedation was reported in 81.3 and 75 % of the olanzapine and risperidone groups respectively. Sedation was the primary reason, in both groups, for medication dose reductions.

Weight gain and sedation have been postulated to be associated with the blockade of central nervous system (CNS) histamine-1 receptors (H1) by the atypical agents (Heisler 1998; Wirshing et al. 1999). In light of this postulated mechanism, it is reasonable to assume that overcoming the H1 blockade with a histamine agonist may aid in reducing these side effects to a tolerable level. Thus, the following study is proposed.

This study is designed as a randomized double blind, parallel group trial to evaluate the effect of modafinil (a proposed H1 agonist) vs. placebo on eating parameters, weight/BMI and sedation in healthy human subjects receiving olanzapine over a three week study period. This project utilizes the current state of the art feeding lab procedures, as reviewed by Mitchell and colleagues (Mitchell et al. 1998), to better characterize the effect of modafinil on olanzapine associated eating behavior. This project will help to determine the efficacy of utilizing a H1 agonist as an adjunctive medication in patients receiving atypical antipsychotic therapy to prevent weight gain and excess sedation.

Interventional
Not Provided
Allocation: Randomized
Endpoint Classification: Pharmacodynamics Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator, Outcomes Assessor)
Primary Purpose: Prevention
Weight Gain
  • Drug: Olanzapine plus modafinil
    Olanzapine 10 mg/d plus modafinil 200 mg/d
    Other Names:
    • Zyprexa
    • Provigil
  • Drug: Olanzapine plus placebo
    Olanzapine 10 mg/d plus placebo
    Other Names:
    • Zyprexa
    • Provigil
  • Experimental: 1
    Olanzapine 10 mg plus modafinil 200 mg
    Intervention: Drug: Olanzapine plus modafinil
  • Placebo Comparator: 2
    Olanzapine plus Placebo
    Intervention: Drug: Olanzapine plus placebo

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
50
August 2007
August 2007   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • Male or female subjects between the ages of 18 and 60 years.
  • Women of child bearing potential must be practicing an accepted method of birth control (barrier method or oral contraceptive) and have a negative pregnancy test at baseline.
  • Subjects must be of good general health by history and physical exam.

Exclusion Criteria:

  • Subjects who are allergic to olanzapine or modafinil.
  • Subjects with a history of a neuroleptic malignant syndrome.
  • Subjects who have a body mass index at visit 2 less than 20 kg/m2 or greater than 27 kg/m2.
  • Subjects who are restrictive eaters according to the restraint subscale of the Eating Disorder Evaluation (EDE).
  • Women who are pregnant or nursing at the time of the study.
  • Subjects who are lactose intolerant.
  • Subjects with diabetes mellitus.
  • Subjects experiencing clinically significant, unstable neurological, cardiac (including cardiac conduction defects), hepatic, renal disease or narrow angle glaucoma.
  • Subjects diagnosed with anorexia nervosa, bulimia nervosa, or binge eating disorder.
  • Subjects currently or with a past history of meeting DSM-IV diagnostic criteria for schizophrenia, schizoaffective disorder, bipolar disorder or substance abuse.
  • Subjects who have participated in an investigational drug study in past 30 days.
  • Subjects who are receiving any prescription medications other than oral contraceptives that would interact with the study medication or influence appetite or weight.
  • Subjects who smoke or use any nicotine products.
Both
18 Years to 60 Years
Yes
Contact information is only displayed when the study is recruiting subjects
United States
 
NCT00636896
FID-US-X297
No
James L. Roerig Pharm.D. Principal Investigator, University of North Dakota
Neuropsychiatric Research Institute, Fargo, North Dakota
  • Eli Lilly and Company
  • University of North Dakota
Principal Investigator: James L Roerig, PharmD University of North Dakota
Neuropsychiatric Research Institute, Fargo, North Dakota
March 2008

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP