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Predicting Antipsychotic Discontinuation in Psychosis

Not Applicable
Conditions
Schizophrenia
Interventions
Device: PET
Behavioral: clinical scale
Registration Number
NCT02884518
Lead Sponsor
Seoul National University Hospital
Brief Summary

The purpose of this study is to determine whether dopamine synthesis capacity by using \[18 fluorine(F)\]-DOPA PET for patients with schizophrenia in the maintenance phase can predict treatment discontinuation.

Detailed Description

There are two groups: the healthy control group (n=12) and the patient group (n=26). The patient group recruits subjects diagnosed with first episode psychosis which occurred within 2 years and having been treated with antipsychotics for 1 year. Participants will complete clinical scales and undergo PET scans. Subjects in the patient group will receive a reduced intake of antipsychotics by 25% after each week of the four-week period in which they will also undergo PET imaging at the baseline, 7 week, and 8 week marks to detect the correlation between the capacity of presynaptic dopamine and relapse in the patients discontinuing treatment.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
35
Inclusion Criteria
  1. Patient group

  2. Patients who met DSM-IV criteria for schizophrenia, schizoaffective disorder, and schizophreniform disorder

  3. patients diagnosed with first episode psychosis which occurred within 2 years and having been treated with antipsychotics for at least 1 year.

  4. Patients who have maintained in the stable state for 3 months without medication change at the baseline.

  5. Healthy control group

  • Healthy controls has no Axis I disorder and do not report any past event of neurological or psychiatric illness assessed by the Structured Clinical Interview for DSM Disorders
Exclusion Criteria
  1. Participants should not have any neurological illness such as head trauma, seizure and meningitis.
  2. Participants should not be diagnosed as Mental retardation(IQ<70)
  3. Participants should not have severe personality disorder, substance abuse or dependence (except for nicotine abuse and dependence) and severe medical conditions.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
healthy control groupclinical scaleScreening tests for healthy volunteers included physical examination, vital signs, laboratory will test (hematology, blood chemistry, and urinalysis), and a 12-lead electrocardiograms. A psychiatric interview with the Structured Clinical Interview for text revision of the Diagnostic and Statistical Manual of Mental Disorders -IV(DSM-IV-TR) Axis I disorders, Research Version, Nonpatient Edition (SCID-I/NP) (First et al. 2002) will be conducted. Subjects with any medically significant abnormality on investigations and/or psychiatric disease will be excluded. Also, healthy control group will take a PET scan at 0, 2, 4, 6, and 8 week and clinical scales at baseline.
healthy control groupPETScreening tests for healthy volunteers included physical examination, vital signs, laboratory will test (hematology, blood chemistry, and urinalysis), and a 12-lead electrocardiograms. A psychiatric interview with the Structured Clinical Interview for text revision of the Diagnostic and Statistical Manual of Mental Disorders -IV(DSM-IV-TR) Axis I disorders, Research Version, Nonpatient Edition (SCID-I/NP) (First et al. 2002) will be conducted. Subjects with any medically significant abnormality on investigations and/or psychiatric disease will be excluded. Also, healthy control group will take a PET scan at 0, 2, 4, 6, and 8 week and clinical scales at baseline.
patient groupPETThe patient group recruits subjects diagnosed with first episode psychosis which occurred within 2 years and having been treated with antipsychotics for 1 year. Subjects in the patient group will receive a reduced intake of antipsychotics by 25% after each week of the four-week period in which they will also undergo PET imaging at the baseline, 7 week, and 8 week marks to detect the correlation between the capacity. And patient group should complete clinical scales at 0, 2, 4, 6, and 8 week.
patient groupclinical scaleThe patient group recruits subjects diagnosed with first episode psychosis which occurred within 2 years and having been treated with antipsychotics for 1 year. Subjects in the patient group will receive a reduced intake of antipsychotics by 25% after each week of the four-week period in which they will also undergo PET imaging at the baseline, 7 week, and 8 week marks to detect the correlation between the capacity. And patient group should complete clinical scales at 0, 2, 4, 6, and 8 week.
Primary Outcome Measures
NameTimeMethod
Ki(cer) of 3,4-dihydroxy-6-18-fluoro-l-phenylalanine ([18 fluorine(F)]DOPA PET)Change from Baseline Ki(cer) of [18 fluorine(F)]DOPA PET at 7 weeks and at 8 weeks

Subjects in the patient group will receive a reduced intake of antipsychotics by 25% after each week of the six-week period in which they will also undergo PET imaging at the baseline and six-week marks to detect the correlation between the capacity of presynaptic dopamine and relapse in the patients discontinuing treatment.

Secondary Outcome Measures
NameTimeMethod
Positive and Negative Syndrome Scale(PANSS)Scaleat 0, 2, 4, 6, and 8 wk

Psychotic symptoms will be assessed by using PANSS at 0, 2, 4, 6, and 8 wk

Brief Psychiatric Rating Scale(BPRS)at 0, 2, 4, 6, and 8 wk

Psychotic symptoms will be assessed by using BPRS at 0, 2, 4, 6, and 8 wk

Young Mania Rating Scale(YMRS)at 0, 2, 4, 6 and 8 wk

Mood symptoms will be assessed by using YMRS at 0, 2, 4, 6 and 8 wk

Columbia Suicide Severity Rating Scale(C-SSR)at 0, 2, 4, 6, and 8 wk

Suicide risk will be assessed by using C-SSR at 0, 2, 4, 6, and 8 wk

Hamilton Depression Rating Scale(HAM-D)at 0, 2, 4, 6 and 8 wk

Mood symptoms will be assessed by using HAM-D at 0, 2, 4, 6 and 8 wk

Kv-Subjective Well-Being Under Neuroleptics Scale(SWN)-Kat 0, 4 and 8 wk

Dysphoria will be assessed by using Kv-SWN-K at 0, 4 and 8 wk

Quality of Life Scale(QoL)at 0 , 4 and 8 wk

QoL will be assessed at 0 , 4 and 8 wk

Adverse effectsat 0 and 4 wk

Adverse effects will be assessed by using side effect rating scale at 0 and 4 wk

Trial Locations

Locations (1)

Seoul National University Bundang Hospital

🇰🇷

Seongnam-si, Gyeonggi-do, Korea, Republic of

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