Tolerability of MDMA in Schizophrenia
试验速览
- 阶段
- 1 期
- 状态
- 招募中
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Positive and Negative Syndrome Scale for Schizophrenia (PANSS): Disorganized speech.
研究概览
简要总结
Impaired social motivation, or "asociality," is a negative symptom of schizophrenia (SCZ) and a cause of significant functional impairment in the illness. Whereas many symptoms of schizophrenia can be treated with antipsychotic medications, deficits in social motivation persist, leading to significant social disability in patients. There is currently no effective treatment for this symptom of the illness. One promising and unexplored avenue to enhance social motivation in schizophrenia is ± 3,4-methylenedioxymethamphetamine (MDMA). MDMA is a psychostimulant that shares some pharmacological properties with amphetamines, but in addition, has pronounced pro-social effects, increasing the motivation to engage socially. In healthy volunteers, it produces feelings of empathy and closeness with others and increases attention to positive social cues, perhaps partly through its effects on the social bonding hormone, oxytocin. MDMA has shown promise in other psychiatric conditions such as PTSD. Thus, MDMA could offer a unique therapeutic benefit in patients with SCZ who suffer from impaired social motivation. The investigators plan to take the first step in testing MDMA as a treatment for these social deficits by testing the tolerability of the drug in patients with SCZ. This will be an open-label, ascending-dose, within-subject trial in which participants will receive 40mg, 80mg, or 120mg of MDMA. The doses will be administered in ascending order, but doses will be stopped if subjects experience moderate or greater psychotic symptoms at 24 hours. This trial will assess the tolerability of the drug in this population and guide in the selection of a maximum well-tolerated dose for future studies. The primary tolerability measure will be clinician-rated psychotic symptoms (disorganized speech, delusions, hallucinations) collected at 24 hours after MDMA administration. The results of this project will lay the foundation for further investigations of MDMA and other psychoactive compounds as a treatment for debilitating and difficult-to-treat social deficits in schizophrenia. Future studies will examine interactions between the effects of psychoactive compounds and nonpharmacologic psychosocial interventions targeting social symptoms.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Ages 18-60
- •able to understand spoken English sufficiently to comprehend testing procedures
- •DSM-5 diagnosis of schizophrenia, based on clinical interview
- •clinical stability (i.e., no inpatient hospitalizations for six months prior to enrollment, no changes in medication in for 6 months prior to enrollment)
排除标准
- •no history of aggressive or suicidal behavior while psychotic
- •no history of IQ less than 70 or developmental disability, based on medical history
- •no clinically significant neurological disease (e.g., epilepsy), or cardiovascular condition (e.g. cardiac arrhythmia) based on medical history
- •no history of serious head injury (i.e., loss of consciousness longer than 1 hour, neuropsychological sequelae, cognitive rehabilitation treatment after head injury) based on medical history
- •no substance or alcohol use disorder in the past six months
- •no sedatives or benzodiazepines within 24 hours of testing
- •no positive urine toxicology screen or visible intoxication on the day of assessment
- •no women who are pregnant or think that they might be pregnant, based on self-report and urine test
- •not currently taking SSRIs or SNRIs
- •no history of NMS or serotonin syndrome
- •No prolongation of the QTc interval on EKG
研究组 & 干预措施
MDMA
Each subject will receive 3 doses of MDMA in ascending order: 40mg, 80mg, 120mg.
干预措施: MDMA 80mg (Drug)
MDMA
Each subject will receive 3 doses of MDMA in ascending order: 40mg, 80mg, 120mg.
干预措施: MDMA 40mg (Drug)
MDMA
Each subject will receive 3 doses of MDMA in ascending order: 40mg, 80mg, 120mg.
干预措施: MDMA 120mg (Drug)
结局指标
主要结局
Positive and Negative Syndrome Scale for Schizophrenia (PANSS): Disorganized speech.
时间窗: 24 hours after each drug session
The PANSS is a validated 30-item clinician-administered scale assessing symptom severity in SCZ. It is widely used to assess the efficacy of antipsychotic medications. Symptoms are rated from 1 (not present) to 7 (extremely severe). The PANSS will be administered at the first session, before drug administration at each drug session, and 24 hours after each drug session. Our primary tolerability outcome measure will be clinician-rated psychotic symptoms on the three core DSM-V symptoms of psychosis (disorganized speech, delusions, hallucinations) on the PANSS 24 hours after each drug session. This is the item assessing disorganized speech.
Positive and Negative Syndrome Scale for Schizophrenia (PANSS): Delusions
时间窗: 24 hours after each drug session
The PANSS is a validated 30-item clinician-administered scale assessing symptom severity in SCZ. It is widely used to assess the efficacy of antipsychotic medications. Symptoms are rated from 1 (not present) to 7 (extremely severe). The PANSS will be administered at the first session, before drug administration at each drug session, and 24 hours after each drug session. Our primary tolerability outcome measure will be clinician-rated psychotic symptoms on the three core DSM-V symptoms of psychosis (disorganized speech, delusions, hallucinations) on the PANSS 24 hours after each drug session. This is the item assessing delusions.
Positive and Negative Syndrome Scale for Schizophrenia (PANSS): Hallucinations
时间窗: 24 hours after each drug session
The PANSS is a validated 30-item clinician-administered scale assessing symptom severity in SCZ. It is widely used to assess the efficacy of antipsychotic medications. Symptoms are rated from 1 (not present) to 7 (extremely severe). The PANSS will be administered at the first session, before drug administration at each drug session, and 24 hours after each drug session. Our primary tolerability outcome measure will be clinician-rated psychotic symptoms on the three core DSM-V symptoms of psychosis (disorganized speech, delusions, hallucinations) on the PANSS 24 hours after each drug session. This is the item assessing hallucinations.
次要结局
未报告次要终点
研究者
Anya Bershad, MD, PhD
Principal Investigator
University of California, Los Angeles