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A Study of the Safety and Efficacy of Injectable Risperidone in the Prevention of Bipolar Mood Episodes

Phase 3
Completed
Conditions
Bipolar Disorder
Interventions
Registration Number
NCT00132678
Lead Sponsor
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Brief Summary

The purpose of this study is to determine if risperidone is effective and safe in the prevention of mood episodes in patients with bipolar 1 disorder.

Detailed Description

RISPERDAL CONSTA (risperidone long-acting injection) may provide substantial improvement, by reducing patient non-compliance, in the long-term treatment of bipolar I disorder. This is a randomized (patients are assigned different treatments based on chance), double-blind, (neither the patient nor the physician knows whether drug or placebo is being taken, or at what dosage) placebo-controlled study to explore the safety and effectiveness of RISPERDAL CONSTA in the prevention of mood episodes in patients with bipolar 1 disorder. This study includes 5 periods: a screening period lasting up to 1 week; an open-label RISPERDAL (oral risperidone) treatment period lasting 3 weeks; an open-label RISPERDAL CONSTA stabilization period lasting 26 weeks; a double-blind period lasting up to 24 months; and an open-label extension with RISPERDAL CONSTA lasting 8 weeks. Efficacy will be assessed using the Young Mania Rating Scale (YMRS), Montgomery-Åsberg Depression Rating Scale (MADRS), Clinical Global Impressions - Severity (CGI-S) scale, Medical Outcomes Study Short Form 36 (SF-36), and the Personal and Social Performance (PSP) scale. Safety will be evaluated throughout the study and includes assessment of adverse events, clinical laboratory tests (including hematology, serum chemistry, blood glucose/lipid profile, prolactin, and urinalysis); electrocardiograms (ECGs), vital signs (pulse and blood pressure), physical examination, body mass index (BMI), and the Extrapyramidal Symptom Rating Scale (ESRS). Oral risperidone (flexible dosage) 1 to 6 mg/day for the first 3 weeks. Risperidone LAI i.m. injections (12.5mg, 25 mg, 37.5 mg, or 50 mg) given every 2 weeks for up to approximately 2.6 years (only 6 months for patients receiving placebo during DB-period)

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
559
Inclusion Criteria
  • Diagnosis of bipolar 1 disorder, currently experiencing a mixed or manic episode or stable
  • Two or more bipolar mood episodes in the last 2 years excluding current episode
  • Negative pregnancy test
Exclusion Criteria
  • History of > than 4 mood episodes a year during the last two years
  • patients experiencing a depressive episode
  • History of antisocial or borderline personality illness
  • Has unstable or serious general medical illness
  • Has received medications disallowed by study criteria.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
001Risperdal ConstaRisperdal Consta 12.5 25 37.5 or 50mg intramuscular (IM) injection every 2 weeks
002PlaceboPlacebo Matching placebo intramuscular (IM) injection every 2 weeks
Primary Outcome Measures
NameTimeMethod
Number of Participants Who Had a Mood Relapse.24 months

Mood Relapse was defined as:

The subject met DSM-IV criteria for a manic, hypomanic, mixed, or depressive episode; or, the subject needed treatment intervention with any mood stabilizer, antipsychotic medication (other than study drug), benzodiazepine (beyond the dosage allowed), or antidepressant medication; or the subject required hospitalization for any bipolar mood episode; or the subject had a YMRS or MADRS score \>12 or a CGI-S score \>4; or a dose increase, or supplementation with oral risperidone or another antipsychotic or mood stabilizer, was needed in the opinion of the investigator.

Secondary Outcome Measures
NameTimeMethod
Change in Young Mania Rating Scale (YMRS) Scores.Baseline and Endpoint (last observation carried forward) of 24 month Double-Blind Period IV

Measure of mania; score range 0 to 60 (lower score = less severity)

Change in Montgomery-Åsberg Depression Rating Scale (MADRS)Baseline and Endpoint (last observation carried forward) of 24 month Double-Blind Period IV

Measure of depression; score range 0 to 60 (lower score = less severity)

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