Salsalate as an Adjunctive Treatment for Patients With Schizophrenia

Phase 4

Completed

Brief Summary: This is a 12-week, open-label trial of salsalate 3 g/day as an adjunctive treatment in 15 schizophrenia subjects to examine salsalate's effect on psychopathology, cognitive functioning, and metabolic parameters.

Potential subjects will be identified by their clinicians at the Freedom Trail Clinic, or Massachusetts General Hospital. A total of 15 subjects will be enrolled.

Detailed Description: The specific aims include:

Primary aims:

1. Examine the efficacy of salsalate (3g/day) in improving positive and negative symptoms as measured by the Positive and Negative Syndrome Scale (PANSS) and the Scale for Assessment of Negative Symptoms (SANS).

2. Examine the efficacy of salsalate in improving cognition as measured by the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) composite score.

Secondary aims:

1. Examine salsalate's effects on inflammatory markers such as high sensitivity C-reactive protein (hs-CRP), TNF-α and IL-6.

Recruitment & Eligibility

Inclusion Criteria

Age 18-65 years;
Diagnosis of schizophrenia or schizoaffective disorder;
Stable dose of the current antipsychotic drug for at least one month;
Well established compliance with outpatient treatment per treating clinician's judgment;
Able to complete the cognitive assessment battery (must be English speaking);
Female subjects will be eligible to participate in the study if they are of non-childbearing potential or of child-bearing potential and willing to practice appropriate birth control methods during the study.

Exclusion Criteria

Inability to provide informed consent;
Current substance abuse;
Psychiatrically unstable per treating clinician's judgment;
Significant medical illnesses including uncontrolled hypertension, diabetes, seizure disorder, severe cardiovascular, cerebrovascular, pulmonary, or thyroid diseases;
Currently on immunosuppressant medication including oral steroids;
Use of anti-coagulants (heparin, LMWH, warfarin, cilostazol, clopidogrel, dabigatran);
History of chronic infection (including, HIV and hepatitis), malignancy, organ transplantation, blood dyscrasia, central nervous system demyelinating disorder, and any other known autoimmune or inflammatory condition;
Experienced asthma, urticaria or allergic type reaction after taking aspirin, salsalate, or other NSAIDS;
Pregnancy or breastfeeding;
Pre-existing chronic tinnitus.
Known hypersensitivity to salsalate.

Arm && Interventions

Group	Intervention	Description
salsalate	salsalate	open-label trial of salsalate 3g/day

Primary Outcome Measures

Name	Time	Method
PANSS Positive Score	Baseline, 12 weeks	Subscale of Positive and Negative Syndrome Scale that specifically measures positive symptoms. The scores range from 7-49, with higher scores representing a worse outcome.
SANS Total Score	Baseline, 12 weeks	Negative symptoms of schizophrenia will be measured by total score on the Scale for Assessment of Negative Symptoms (SANS; score range 0-100). Higher scores correspond with worse outcomes.
MATRICS Composite Score	Baseline, 12 weeks	Improved cognition will be measured using the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) assessment. The MATRICS assessment includes a battery of tests, and the composite t-score measures cognition across 7 domains including speed of processing, attention/vigilance, working memory, verbal learning, visual learning, reasoning and problem solving, and social cognition. A higher score indicates better cognition.
PANSS Total Score	Baseline and 12 weeks	Positive and negative symptoms of schizophrenia will be measured by total score on all subscales of the Positive and Negative Syndrome Scale (PANSS; score range 30-210). Higher scores correspond with worse outcomes.
PANSS- Negative Score	Baseline, 12 weeks	Subscale of Positive and Negative Syndrome Scale that specifically measures negative symptoms. The scores range from 7-49, with higher scores representing a worse outcome.

Secondary Outcome Measures

Name	Time	Method
Hs-CRP	Baseline, 12 weeks	High-sensitivity C-reactive protein (hs-CRP) will be measured in mg/L in order to detect inflammation. Higher hs-CRP values correspond to higher levels of inflammation.
TNF-alpha	Baseline,12 weeks	Tumor necrosis-alpha factor will be measured to assess inflammation levels.
IL-6	Baseline, week 12	IL-6 (interleukin 6) is a marker used to measure inflammation.