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Determining Metabolic Effects of Valproate and Antipsychotic Therapy
This study is currently recruiting participants.
Verified by National Institute of Mental Health (NIMH), March 2009
First Received: September 9, 2005   Last Updated: March 10, 2009   History of Changes
Sponsor: National Institute of Mental Health (NIMH)
Information provided by: National Institute of Mental Health (NIMH)
ClinicalTrials.gov Identifier: NCT00167934
  Purpose

This study will determine the metabolic processes responsible for high levels of blood glucose, metabolism disorders, and weight gain in people with schizophrenia who have been treated with antipsychotic medications in combination with valproate.


Condition Intervention
Schizophrenia
Drug: Valproate
Drug: Placebo

Study Type: Interventional
Study Design: Treatment, Randomized, Single Blind (Subject), Placebo Control, Parallel Assignment, Pharmacodynamics Study
Official Title: Metabolic Effects of Valproate and Antipsychotic Therapy

Resource links provided by NLM:


Further study details as provided by National Institute of Mental Health (NIMH):

Primary Outcome Measures:
  • Oral glucose tolerance test (fsOGTT) and hyperinsulinemic pancreatic clamp [ Time Frame: Measured at baseline and Weeks 6 and 12 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Body composition using dual energy x-ray absorptiometry, magnetic resonance scans, and anthropomorphic measurements [ Time Frame: Measured at baseline and Weeks 6 and 12 ] [ Designated as safety issue: No ]

Estimated Enrollment: 88
Study Start Date: December 2004
Estimated Study Completion Date: December 2008
Estimated Primary Completion Date: December 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo: Placebo Comparator
50% of participants will receive placebo
Drug: Placebo
Placebo given at same frequency as Valproate
Experimental: Experimental
50% of participants will receive Depakote ER
Drug: Valproate
Depakote ER 500 mg to 3000 mg taken every night

Detailed Description:

This project aims to study the whole-body metabolic processes responsible for hyperglycemia, dyslipidemia and increased adiposity in schizophrenia patients treated with antipsychotic medications in combination with valproate. The project hypothesizes that combined treatment with valproate and antipsychotic medications will decrease insulin sensitivity at the level of skeletal muscle, liver and adipose tissue, in comparison to antipsychotic monotherapy. The decrease in insulin sensitivity is hypothesized to be associated with defects in glucose and lipid metabolism and increased adiposity

Treatment effects of antipsychotic/valproate combination therapy on different components of insulin secretion and action, and treatment effects on abdominal versus peripheral adiposity, are unknown despite the availability of gold-standard methods and the prognostic significance of these issues. Relevant data are needed to target basic research, to identify the potential for acute and long-term complications, and to plan therapeutic interventions. The following specific aims will be addressed in non-diabetic schizophrenia patients treated with atypical antipsychotics who will be randomized to open label treatment with either valproate or no adjuvant. Evaluations are performed at baseline and 3 months of treatment.

  Eligibility

Ages Eligible for Study:   18 Years to 60 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Meets DSM-IV criteria for schizophrenia, any type, treated with the same antipsychotic for at least 6 months
  • No antipsychotic medication dose changes for 1 month, and no other medication changes for 1 month prior to study entry

Exclusion Criteria:

  • Meets DSM-IV criteria for substance abuse within 3 months of study entry
  • Involuntary legal status (as per Missouri law)
  • Any serious medical disorder that may confound the assessment of relevant biologic measures or diagnosis, including: significant organ system dysfunction, metabolic diseases, type 1 or 2 diabetes mellitus, pregnancy, endocrine disease, coagulopathy, anemia, or acute infection
  • Currently taking more than one antipsychotic medication
  • Currently taking prescription medications (except certain psychotropic medications as discussed below), including oral contraceptive pills, any glucose lowering agent, lipid lowering agent, exogenous testosterone, recombinant human growth hormone, or any other endocrine agent that might confound substrate metabolism
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00167934

Contacts
Contact: Martha J. Hessler, BS 314-362-2423 hesslema@psychiatry.wustl.edu
Contact: Julie Schweiger 314-362-3153 schweigj@psychiatry.wustl.edu

Locations
United States, Missouri
Washington University School of Medicine Recruiting
St. Louis, Missouri, United States, 63110
Contact: Elizabeth T Westerhaus, MA     314-747-1134     westerhe@psychiatry.wustl.edu    
Contact: Julie Schweiger     314-362-3153     schweigj@psychiatry.wustl.eddu    
Principal Investigator: Dan W. Haupt, MD            
Sponsors and Collaborators
Investigators
Principal Investigator: Dan W. Haupt, MD Washington University School of Medicine
  More Information

Additional Information:
Publications:
Responsible Party: Washington University School of Medicine ( Daniel W. Haupt MD )
Study ID Numbers: K23 MH067795, DAHBR AK-TNET1
Study First Received: September 9, 2005
Last Updated: March 10, 2009
ClinicalTrials.gov Identifier: NCT00167934     History of Changes
Health Authority: United States: Federal Government

Keywords provided by National Institute of Mental Health (NIMH):
Diabetes
Metabolic

Additional relevant MeSH terms:
Neurotransmitter Agents
Tranquilizing Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Psychotropic Drugs
Central Nervous System Depressants
Enzyme Inhibitors
Antipsychotic Agents
Antimanic Agents
Valproic Acid
Pharmacologic Actions
Schizophrenia
Mental Disorders
Therapeutic Uses
GABA Agents
Central Nervous System Agents
Anticonvulsants
Schizophrenia and Disorders with Psychotic Features

ClinicalTrials.gov processed this record on November 20, 2009