D-cycloserine Augmentation of Cognitive Remediation in Schizophrenia
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Purpose
This study seeks to examine the effects of D-cycloserine augmentation on cognitive remediation for patients diagnosed with schizophrenia. We will test the hypotheses that D-cycloserine will significantly improve cognitive performance, negative symptoms, and measures of functioning compared to placebo when combined with eight weeks of cognitive remediation. We expect that these effects will persist when assessed at six-month follow up.
| Condition | Intervention |
|---|---|
|
Schizophrenia |
Drug: D-cycloserine Drug: Placebo Behavioral: Cognitive Remediation |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Placebo-controlled Trial of D-cycloserine Augmentation of Cognitive Remediation in Schizophrenia |
- Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) [ Time Frame: Weeks 0 and 8, and Month 6 after cognitive remediation completion ] [ Designated as safety issue: No ]
- Positive and Negative Syndrome Scale (PANSS) [ Time Frame: Weeks 0, 4 and 8, and Month 6 after cognitive remediation completion ] [ Designated as safety issue: No ]
- Scale for Assessment of Negative Symptoms (SANS) [ Time Frame: Weeks 0, 4 and 8, and Month 6 after cognitive remediation completion ] [ Designated as safety issue: No ]
- Global Assessment Scale (GAS) [ Time Frame: Weeks 0, 4 and 8, and Month 6 after cogntive remediation completion ] [ Designated as safety issue: No ]
- Heinrich Quality of Life Scale (QoL) [ Time Frame: Weeks 0, 4 and 8, and Month 6 after cognitive remediation completion ] [ Designated as safety issue: No ]
- Calgary Depression Scale for Schizophrenia (CDSS) [ Time Frame: Weeks 0, 4 and 8, and Month 6 after cognitive remediation completion ] [ Designated as safety issue: No ]
- Clinical Global Impression (CGI) [ Time Frame: Weeks 0 and 8, and Month 6 after cogntive remediation completion ] [ Designated as safety issue: No ]
- Side Effects Checklist (SEC) [ Time Frame: Weeks 0 - 8, and Month 6 after cogntive remediation completion ] [ Designated as safety issue: Yes ]
- Brain Fitness Program Processing Speed Assessment [ Time Frame: Weeks 0, 1, 2, 4 and 8 ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 120 |
| Study Start Date: | August 2009 |
| Estimated Study Completion Date: | June 2011 |
| Estimated Primary Completion Date: | May 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: D-cycloserine
Participants will receive D-cycloserine weekly, one hour before the first cognitive remediation session of the week, for eight weeks.
|
Drug: D-cycloserine
50 mg by mouth one hour before first cognitive remediation session each week for eight weeks.
Other Name: Cycloserine
Behavioral: Cognitive Remediation
40 one-hour daily sessions of cognitive remediation (Brain Fitness Program) over eight weeks.
Other Name: Brain Fitness Program
|
|
Placebo Comparator: Placebo
Participants will receive placebo weekly, one hour before the first cognitive remediation session of the week, for eight weeks.
|
Drug: Placebo
Placebo by mouth one hour before first cognitive remediation session each week for eight weeks.
Behavioral: Cognitive Remediation
40 one-hour daily sessions of cognitive remediation (Brain Fitness Program) over eight weeks.
Other Name: Brain Fitness Program
|
Detailed Description:
We propose to conduct an 8-week, placebo-controlled, double-blind, parallel-group trial of D-cycloserine augmentation of cognitive remediation in 80 stable schizophrenia outpatients. The primary outcome measure is change in performance on the MATRICS cognitive battery composite score after 8 weeks. Secondary outcome measures include a measure of processing speed assessed after weeks 1, 2, 4 & 8, and changes in negative symptoms and measures of functioning after 4 and 8 weeks. In addition, all outcome measures will be repeated at 6 months to assess persistence of benefit.
Hypotheses:
- D-cycloserine will significantly improve cognitive performance as measured by the composite score on the MATRICS battery compared to placebo after 8 weeks of cognitive remediation.
- D-cycloserine will significantly improve negative symptoms as measured by the SANS compared to placebo after 8 weeks when combined with cognitive remediation.
- D-cycloserine will significantly improve measures of functioning (GAS, QoL and CGI) at 8 weeks compared to placebo when combined with cognitive remediation.
- D-cycloserine effects on cognition, negative symptoms and functioning will persist compared to placebo when assessed at 6-month follow-up.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Male or female
- Age 18-65 years
- Diagnosis of schizophrenia or schizoaffective disorder, depressed type
- Stable dose of antipsychotic for at least 4 weeks
- Able to provide informed consent
- Able to complete a cognitive battery
- Able to perform the cognitive remediation exercises
Exclusion Criteria:
- Current treatment with clozapine
- Dementia
- Seizure disorder
- Unstable medical illness
- Renal insufficiency measured as eGFR >60mg/dL/min
- Active substance abuse: positive urine toxic screen
- Pregnancy, nursing, or unwilling to use appropriate birth control measures during participation if female and fertile.
Contacts and Locations| Contact: Timothy B. Creedon, B.A. | 617-912-7864 | tcreedon@partners.org |
| Contact: Lisa H. Raeke, M.A. | 617-912-7840 | lraeke@partners.org |
| United States, Massachusetts | |
| Massachusetts General Hospital | Recruiting |
| Boston, Massachusetts, United States, 02114 | |
| Contact: Lisa Raeke, MA 617-912-7840 lraeke@partners.org | |
| Contact: Timothy Creedon, BA 617-912-7868 tcreedon@partners.org | |
| Principal Investigator: Donald C. Goff, M.D. | |
| Principal Investigator: | Donald C. Goff, M.D. | Massachusetts General Hospital |
More Information
No publications provided
| Responsible Party: | Donald C. Goff, M.D., Massachusetts General Hospital |
| ClinicalTrials.gov Identifier: | NCT00963924 History of Changes |
| Other Study ID Numbers: | 2008P002237, 5P50 MH060450, DATR A3-NSC |
| Study First Received: | August 20, 2009 |
| Last Updated: | August 20, 2009 |
| Health Authority: | United States: Federal Government United States: Food and Drug Administration United States: Institutional Review Board |
Keywords provided by National Institute of Mental Health (NIMH):
|
Cognitive Impairment Neuroplasticity D-cycloserine NMDA Anti-Bacterial Agents |
Mental Disorders Psychotic Disorders Antitubercular Agents Schizophrenia and Disorders with Psychotic Features Schizoaffective Disorder |
Additional relevant MeSH terms:
|
Schizophrenia Schizophrenia and Disorders with Psychotic Features Mental Disorders Antitubercular Agents Cycloserine Anti-Bacterial Agents Anti-Infective Agents |
Therapeutic Uses Pharmacologic Actions Anti-Infective Agents, Urinary Renal Agents Antibiotics, Antitubercular Antimetabolites Molecular Mechanisms of Pharmacological Action |
ClinicalTrials.gov processed this record on June 18, 2013