Famotidine in Schizophrenia

Phase 2

Brief Summary: Objective of the trial is to study if famotidine add-on treatment is more effective than placebo add-on in reducing symptoms of schizophrenia among patients receiving insufficient response to ongoing antipsychotic treatment.

Recruitment & Eligibility

Inclusion Criteria

ICD-10 diagnosis of schizophrenia (F20.00-20.39, F20.5, F20.9) who have had the disorder for at least 5 years and who are on disability pension. (This means that their treatment response is not satisfactory and for the purpose of this study, the subjects are potentially treatment resistant).
Clinical Global Impression (CGI) severity score of at least 3.
No changes in schizophrenia treatment within 12 weeks before study inclusion.
Written informed consent
The subjects must fulfil schizophrenia criteria both according to DSM- IV (295.10, .20, .30, .60, .90) (American Psychiatric association) and the Research Diagnostic Criteria for schizophrenia (RDC) [40]. They must also have at least mild residual symptoms (CGI 3 points). The DSM-IV diagnosis will be verified by use of the SCID-I [41]. The DSM-IV is clearly the most commonly used in psychiatric research, so this is important to be able to generalize the findings. However, several previous studies have used the RDC, so to be able to compare the results, we will diagnose the patients according to both systems.
Women of child-bearing age will be included only of they use adequate contraception, or if we can otherwise verify that the subject is not pregnant (s-HCG), the possibility of pregnancy is negligible (e.g. the personnel of the housing facility reports that the person has not had sexual relationships for years) and the subject approves to remain sexually abstinent for the duration of the study.

Exclusion Criteria

Epilepsy or a history of unclear seizures, stroke, Parkinson's disease, AIDS
History of substance addiction or abuse within 3 months prior to enrolment.
Individuals who are deemed at risk for aggressive behaviour or suicide
If their laboratory tests, EKG or other clinical observation warrants exclusion, they will be excluded
Women who are pregnant or breast-feeding subjects will not be included in the study.
Patients with any serious unstable physical illness will also be excluded
Patients who have been deemed to be legally incapacitated according to Finnish or Swedish law.
Regular Uuse of H2-antagonists as prescribed by a physician.
Known allergy to famotidine or any other component of interventional drug will be excluded.
Ongoing treatment with clozapine and dixyrazine.
Clinical condition "very much improved" or "much improved", assessed by CGI, during the placebo lead-in
Renal insufficiency (P-creatinine not within normal range. Glomerular filtration rate <30 ml/min according to the Cockcroft-Gault formula. )
Liver insufficiency (S-ALAT elevated more than 2-fold above the laboratory specific normal range)

Arm && Interventions

Group	Intervention	Description
Famotidine	Famotidine	Famotidine 100mg x 2 orally
Placebo	Placebo	Placebo control

Primary Outcome Measures

Name	Time	Method
Change from Baseline in Positive and Negative Syndrome Scale (PANSS) at 8 weeks	Rating at start of treatment (0 weeks) and at end of treatment (8 weeks)	In addition PANSS ratings are done at screening, every two weeks during treatment and two weeks after end of treatment.

Secondary Outcome Measures

Name	Time	Method
Change from Baseline in The Overall Anxiety Severity and Impairment Scale (OASIS)at 8 weeks	Rating at start of treatment (0 weeks) and at end of treatment (8 weeks)
Change from Baseline in Clinical Global Impression (CGI) scale at 8 weeks	Rating at start of treatment (0 weeks) and at end of treatment (8 weeks)	In addition CGI ratings are done at screening, every two weeks during treatment and two weeks after end of treatment.
Change from Baseline in Calgary Depression Scale (CDS) at 8 weeks	Rating at start of treatment (0 weeks) and at end of treatment (8 weeks)
Change from Baseline in CogState scores at 8 weeks	Rating at start of treatment (0 weeks) and at end of treatment (8 weeks)	A standardized, language independent computerized battery of cognitive tests (CogState®). This battery has been validated and shown to be a sensitive indicator of mild impairments in the following cognitive domains: psychomotor speed, attention, working memory and episodic learning and memory.
Change from baseline in nightly sleep duration measured with actigraphy at 8 weeks	Measurement at start of treatment (0 weeks) and at end of treatment (8 weeks)	Average nightly sleep duration of seven nights before and after intervention measured with an actigraph

Locations (6): Helsinki University
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Helsinki, Finland
Norra Stockholms Psykiatri, Stockholm County Council
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Stockholm, Sweden
Social services and Healthcare, City of Helsinki
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Helsinki, Finland
Karolinska Institutet
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Stockholm, Sweden
Kellokoski Hospital
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Hyvinkää, Finland
Helsinki University Central Hospital Psychiatry Centre
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Helsinki, Finland