A Randomised Controlled Trial of Selective Estrogen Receptor Modulators (SERMs) - A Potential Treatment for Psychotic Symptoms of Schizophrenia in Men?
Overview
- Phase
- Phase 4
- Status
- Completed
- Sponsor
- The Alfred
- Enrollment
- 13
- Locations
- 1
- Primary Endpoint
- Change from Baseline to 12 week follow up in PANSS-positive and negative syndrome scale
Overview
Brief Summary
The aim of this project is to investigate the effect of Raloxifene 120mg in men with schizophrenia. This trial will adopt a 12 week randomised controlled model.
Hypotheses 1: That the men receiving adjunctive selective estrogen receptor modulators (SERM) will have a significantly greater reduction in psychosis symptoms over the course of the study than men receiving adjunctive placebo.
Hypotheses 2: That the men receiving adjunctive SERM will have a significantly greater improvement in cognitive function than men receiving adjunctive placebo
Detailed Description
With the recent advent of selective estrogen receptor modulators (SERMS), such as raloxifene hydrochloride, there is the potential to harness the positive estrogenic effect on central nervous system (CNS) neurotransmitter systems. While the CNS effects of raloxifene have not been fully studied, its actions are mediated through binding to estrogen receptors and can thereby regulate gene expression that is ligand, tissue or gene specific. By inference then, raloxifene would be expected to impact on dopamine and serotonin pathways in a similar fashion to unconjugated estrogen.
This study aims to examine the impact of adjunctive SERM (120mg oral Raloxifene daily) treatment on the psychopathology and cognition of men with schizophrenia and related disorders
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 45 Years (Adult)
- Sex
- Male
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Physically well
- •DSM-IV diagnosis of schizophrenia, schizoaffective or schizophreniform
- •18- 45 years
- •Able to give informed consent
- •PANSS total score \> 60 (1 - 7 scale) and a score of 4 (moderate) or more on two or more of the following PANSS items: delusions, hallucinatory behaviour, conceptual disorganization or suspiciousness
Exclusion Criteria
- •Patients with known abnormalities in the hypothalamo-pituitary gonadal axis, thyroid dysfunction, central nervous system tumours, active or past history of a venous thromboembolic event.
- •Patients with any significant unstable medical illness such as epilepsy and diabetes or known active cardiac, renal or liver disease; presence of illness causing immobilization.
- •Patients whose psychotic illness is directly related to illicit substance use or who have a history of substance abuse or dependence during the last six months, or consumption of more than 30gm of alcohol (three standard drinks) per day
- •Smoking more than 20 cigarettes per day.
- •Use of any form of estrogen, progestin or androgen as hormonal therapy, or antiandrogen including tibolone or use of phytoestrogen supplements as powder or tablet.
Arms & Interventions
Raloxifene Hydrochloride 120mg oral per day
120mg raloxifene plus antipsychotic drug
Intervention: Raloxifene Hydrochloride (Drug)
Placebo tablet - one per day
Lactose pill plus antipsychotic medication
Intervention: Placebo (Drug)
Outcomes
Primary Outcomes
Change from Baseline to 12 week follow up in PANSS-positive and negative syndrome scale
Time Frame: baseline, week2, week4, week 6, week 8, week 10, week 12
Positive and Negative Symptom Schedule (PANSS): The PANSS will be performed at baseline and at weeks 2,4,6,8,10 and 12. The PANSS consists of a Positive Scale (7 positive symptom constructs), a Negative Scale (7 negative symptom constructs) and a General Psychopathology Scale (16 symptom constructs). For each patient, the scale will be administered by the same trained rater. The PANSS provides a well standardised method of evaluating and monitoring psychotic symptoms. The rater is trained and recertified against an internationally recognised "gold standard".
Secondary Outcomes
- MATRICS Consensus Cognitive Battery(Baseline, week 12)
- Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)(Baseline, week 12)
- Montgomery Asberg Depression Rating Scale (MADRS):(baseline, week2, week4, week 6, week 8, week 10, week 12)
Investigators
Jayashri Kulkarni, Professor
Selective Estrogen Receptor Modulators (SERMs) - A Potential Treatment for Psychotic Symptoms of Schizophrenia in Men?
The Alfred