Treatment of Early Onset Schizophrenia Spectrum Disorders (TEOSS)

Phase 4

Completed

• Conditions: Schizophrenia
• Interventions: Drug: Olanzapine (enrollment closed in this treatment); Drug: Risperidone; Drug: Molindone

• Registration Number: NCT00053703
• Lead Sponsor: University of North Carolina, Chapel Hill

Brief Summary

This study will evaluate the safety and efficacy of risperidone (Risperdal®), olanzapine (Zyprexa®), and molindone (Moban®) for the treatment of children and adolescents with schizophrenia or schizoaffective disorder.

Detailed Description

Little research has been conducted on the use of psychotropic agents in children and adolescents with early onset schizophrenia spectrum disorders. This study will compare antipsychotic agents with different mechanisms of action in children and adolescents who have schizophrenia or schizoaffective disorder with active psychotic symptoms.

Participants are randomly assigned to receive risperidone (Risperdal), olanzapine (Zyprexa), or molindone (Moban) for 8 weeks. After 11/2005, no additional patients will be assigned to olanzapine treatment. Patients with significant improvement and without side effects continue maintenance therapy for another 44 weeks. Participants who show significant negative symptoms after 8 weeks may be started on a mood stabilizer or antidepressant. Weight gain, metabolic changes, neurocognition, functional outcome, psychotic symptoms, extrapyramidal side effects, and the ability to sustain effective therapy over time are assessed.

Study Timeline

• Study Start: 2002-02
• Study First Submitted: 2003-02-04
• Study First Submitted QC: 2003-02-04
• Study First Posted: 2003-02-05
• Primary Completion: 2007-05
• Study Completion: 2007-05
• Results First Submitted: 2013-09-16
• Status Verified: 2014-02
• Results First Submitted QC: 2014-02-07
• Last Update Submitted: 2014-02-07
• Results First Posted: 2014-03-26
• Last Update Posted: 2014-03-26

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 116

Inclusion Criteria

• Schizophrenia, schizophreniform disorder, or schizoaffective disorder with psychotic symptoms
• Free of depot antipsychotic medication for at least 6 months. Oral antipsychotic medication at entry into the study is allowed, provided the participant has not had an adequate trial during the present episode of psychosis.
• If taking antidepressant or mood stabilizing medication, stable dosing for at least 30 days prior to entry.
• Good physical health

Exclusion Criteria

• Risperidone (RIS), olanzapine (OLA)*, or molindone (MOL) for 8 weeks or more during THIS episode, with 2 weeks at the maximal dose (6 mg/day of RIS, 20 mg/day of OLA, or 140 mg/day of MOL)
• If using antidepressant and/or mood stabilizing medications, treatment for fewer than 30 days immediately before entry
• Intolerance or nonresponse to RIS, OLA*, or MOL during any previous treatment
• Bipolar affective disorder,post traumatic stress disorder, personality disorder, or psychosis not otherwise specified
• Currently meeting Diagnostic and Statistical Manual version IV (DSM IV) criteria for major depression episode
• DSM IV criteria for substance abuse or dependence with intention to continue illicit substance abuse
• Endocrinological or neurological conditions which confound the diagnosis or are a contraindication to treatment with antipsychotics
• Mental retardation
• Risk of suicide or homicide that is not adequately controlled in the current setting
• Pregnancy or refusal to practice contraception during the study

"*" OLA exclusion not applicable after 11/2005

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
olanzapine	Olanzapine (enrollment closed in this treatment)	oral olanzapine 5-20mg per day for up to 52 weeks
risperidone	Risperidone	oral risperidone 0.5mg to 6mg daily for up to 52 weeks
molindone	Molindone	oral molindone from 10-140mg/daily for up to 52 weeks

Primary Outcome Measures

Name	Time	Method
Change From Baseline in Positive and Negative Syndrome Scale (PANSS) Total Score at 8 Weeks	8 weeks	Assessed with the Positive and Negative Syndrome Scale in which a clinician rates various psychotic symptoms on the basis of observation of the participant, interview with the participant, and review of all other available information including informant reports. The scale consists of 30 items which are rated categorically between 1 - no symptoms to 7 - extreme symptoms. The minimal score is 0 and the maximal score is 210, with higher scores reflecting more symptoms. Typically scores \> that 60 are considered clinically significant.
Change From Baseline in PANSS Positive Symptom Subscale Score at 8 Weeks.	8 weeks	The PANSS (described above) includes 7 items that reflect positive psychotic symptoms such as hallucinations and delusions. As are all items within the PANSS, items are categorically rated by the clinician between 0 - no symptoms to 7 extreme symptoms. The minimal score is 0 reflecting no positive symptoms to 49 reflecting that all items were extreme. Higher scores reflect more severe symptoms. Scores above 18 are usually clinically significant.
Change From Baseline in PANSS Negative Symptom Subscale at Week 8	8 weeks	The PANSS (described above) includes 7 items that reflect negative psychotic symptoms such as amotivation and social withdrawal. As are all items within the PANSS, items are categorically rated by the clinician between 0 - no symptoms to 7 extreme symptoms. The minimal score is 0 reflecting no positive symptoms to 49 reflecting that all items were extreme. Higher scores reflect more severe symptoms. Scores above 18 are usually clinically significant.

Secondary Outcome Measures

Name	Time	Method
Change From Baseline in Weight at Week 8	8 weeks	change in weight from baseline to week 8 in kg
Change From Baseline in Barnes Akathisia Scale at Week 8	8 weeks	Barnes Akathisia Scale is a clinician rated scale which considers information based on observation of the participant as well as participant report. The scale includes 3 items rated between 0- none to 3 severe and 1 summary item rated between 0 none to 5 severe. All items are summed to obtain the total score. The minimal total score is 0 and the maximal score is 14 with higher scores reflecting more severe akathisia. A score of 4 or more is clinically significant.
Change From Baseline in Body Mass Index Change, kg/m2, at Week 8	8 weeks	Change from baseline in Body Mass Index Change, kg/m2, at week 8, last observation was carried forward for individuals who withdrew from treatment early.

Trial Locations

Locations (4)

University of Washington; 🇺🇸 Seattle, Washington, United States

University of North Carolina; 🇺🇸 Chapel Hill, North Carolina, United States

Cambridge Health Alliance; 🇺🇸 Medford, Massachusetts, United States

University Hospitals of Cleveland; 🇺🇸 Cleveland, Ohio, United States