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Pan European Collaboration on Antipsychotic Naive Schizophrenia (PECANS)

Not Applicable
Completed
Conditions
Schizophrenia
Interventions
Registration Number
NCT01154829
Lead Sponsor
University of Copenhagen
Brief Summary

The investigators want to relate disturbances in first-episode schizophrenic patients in (dopaminergic) D2 receptors, brain structure, brain function, and information processing to each other and to psychopathology. Additionally, the investigators want to examine the influence of D2 receptor blockade on these disturbances. The investigators expect disturbances in the dopaminergic system at baseline to correlate with specific structural and functional changes and with disruption in information processing as measured with psychophysiological and neurocognitive methods - and investigators expect D2 receptor blockade to reverse some of the functional and cognitive impairments.

Detailed Description

The study is designed as a 6 week case-control follow-up study of 70 AN FE pt. with SCZ and 70 controls matched with regard to age, gender, and parental socio-economic status. All subjects will be examined with a diagnostic interview (SCAN, Schedule for Clinical Assessment in Neuropsychiatry), medical and family history, and physical examination before inclusion. At baseline all subjects will be examined with single photon emission computed tomography (SPECT), MRI, fMRI, psychophysiology, neurocognition. In addition, they will be screened for drugs, genetic testing, and ECG. Patients will further be examined with clinical validated rating scales to measure psychopathology, subjective well-being, and side-effects. After a period of 6 weeks all assessments are repeated. During that period patients will be treated with amisulpride, while healthy controls will receive no treatment at all. Efficacy of antipsychotic treatment will be evaluated after this initial period of 6 weeks. Based on this evaluation it will be decided to either continue the current (amisulpride) antipsychotic treatment, or to switch to aripiprazole. Efficacy of aripiprazole is evaluated on a monthly basis, if the patient does not respond well enough, than the treatment will be adapted individually. Regardless of treatment, all subjects will be re-assessed in the same test battery as mentioned above, except for SPECT and fMRI, after a period of 6, 12, and 24 months. The developement in specific disturbances and the relationship between these will be analysed.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
136
Inclusion Criteria

For patients: meeting diagnostic criteria for schizophrenia according to ICD 10 or DSM IV antipsychotic naive The controls will be matched to the patients according to gender age and parental socio-economic status.

Exclusion Criteria

Patients: mental retardation, other chronic diseases, use of antidepressive medicine during the last month,being pregnant, on going substance abuse

Controls: psychiatric diagnosis, psychiatric diagnosis in first-degree relatives,on going drug abuse, mental retardation -

Study & Design

Study Type
INTERVENTIONAL
Study Design
FACTORIAL
Arm && Interventions
GroupInterventionDescription
second choice treatmentaripiprazoletreatment with aripiprazole
first choice treatmentamisulprideTreatment with amisulpride
Primary Outcome Measures
NameTimeMethod
Relationship between specific neuropsychiatric measures and improvement on PANSS scores6 weeks of medical treatment
Secondary Outcome Measures
NameTimeMethod
The relation between D2 binding potential (SPECT) and reward related brain activity (fMRI BOLD response) before and after D2 blockadeBaseline, 6 weeks
Time/dose improvement on PPI and other psychophysiological measures of early information processing after D2 blockadeBaseline, 2 and 6 weeks, 6,12,24 months
Disturbances in reward related fMRI BOLD response in antipsychotic naive schizophrenic patientsBaseline and 6 weeks follow up
Structural changes in grey and white matter before and after D2 blockade6 weeks, 6, 12 and 24 months,
Cognitive differences at baseline and changes over time after D2 blockadeBaseline, 6 weeks, 6,12,24 months
The effect of D2 blockade on reward related fMRI BOLD response6 weeks of medical treatment

Trial Locations

Locations (1)

Center for Neuropsychiatric Schizophrenia Research, University of Copenhagen, Psychiatric Center Glostrup

🇩🇰

Glostrup, Denmark

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