Effects of Risperdal Consta Versus Oral Antipsychotic Medication on Clinical and Functional Outcome and Neurocognition in First-episode Schizophrenia
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 入组人数
- 126
- 试验地点
- 1
- 主要终点
- Number of Participants Who Had an Exacerbation or Relapse of Psychotic Symptoms
研究概览
简要总结
This study will determine the effectiveness of oral risperidone versus long-acting injectable risperidone in treating people with first-episode schizophrenia.
详细描述
Schizophrenia is a severely disabling brain disorder. People with schizophrenia often experience hallucinations, delusions, thought disorders, and movement disorders. Proper treatment of first-episode schizophrenia may increase the chances of controlling disease progression on a long-term basis. People experiencing their first episode of schizophrenia are more responsive to treatment than those with chronic schizophrenia, but are also more susceptible to adverse treatment side effects. Atypical antipsychotic medications have been shown to produce fewer adverse side effects than older "typical" antipsychotics. Risperidone is a type of atypical antipsychotic medication that is used to control the symptoms of schizophrenia. This study will determine the effectiveness of oral risperidone versus long-acting injectable risperidone in treating people with first-episode schizophrenia.
Participants in this open label study will be randomly assigned to receive either orally administered risperidone or long-acting risperidone administered via injection. Participants assigned to oral risperidone will receive medication in doses that are determined to be optimal by the study psychiatrist. Participants assigned to long-acting risperidone will receive an injection of risperidone once every 2 weeks. Dosages will begin at 25 mg and will be adjusted as necessary to achieve the optimal dosage. Following 2 to 3 months to achieve outpatient risperidone dosage stabilization, the randomized medication conditions will begin and participants will be monitored for 1 year. Study visits will occur once weekly throughout the study. They will include group therapy meetings focused on everyday living skills; family education about schizophrenia; assessments of medication response; and individual meetings with a case manager for counseling and evaluations of schizophrenia symptoms.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years(Adult)
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •DSM-IV diagnosis of schizophrenia, schizoaffective disorder (depressed type), or schizophreniform disorder
- •First major episode of psychotic symptoms occurred within 2 years prior to study entry
- •Participant in the UCLA Center for Neurocognition and Emotion in Schizophrenia
排除标准
- •Neurological disorder or injury (e.g., encephalitis, epilepsy, traumatic brain injury)
- •Mental retardation (e.g., premorbid IQ less than 70)
- •Significant alcohol or substance abuse within 6 months prior to study entry
- •Inability to complete research measures in English
- •Any condition that may make risperidone use medically inadvisable
研究组 & 干预措施
Long-acting injectible risperidone
Participants who are randomly assigned to this arm will be administered the long-acting injectible form of risperidone (Risperdal Consta) every two weeks, plus group skills training and case management, for 12 months.
干预措施: Risperidone in Long-Acting Injectable Form (Consta) (Drug)
Oral risperidone
Participants who are randomly assigned to this arm will be treated with the oral version of risperidone (Risperdal) daily, plus group skills training and case management, for 12 months.
干预措施: Oral Risperidone (Drug)
结局指标
主要结局
Number of Participants Who Had an Exacerbation or Relapse of Psychotic Symptoms
时间窗: Occurrence after randomization and until end of study participation (up to 12 mos.)
Dichotomous measure: Presence of any of three psychotic relapse or exacerbation categories scored from the Brief Psychiatric Rating Scale (BPRS) occurring any time after randomization and until end of study participation (up to 12 mos.).
Number of Participants Who Returned to Work or School (SAS Work Section)
时间窗: Measured from Baseline to Month 12
The Social Adjustment Scale records the return to work or school and the number of weeks in work or school during each 3-month period. For this outcome, outcome as dichotomized as 0 if an individual did not return to work or school and 1 if they did return to competitive work or regular school enrollment.
Number of Weeks Maintaining Work or School (SAS)
时间窗: Cumulative total measured from Baseline to Month 12
Measured as the number of weeks in which a participant has competitive employment or attends regular school courses. Possible range is 0 to 52 weeks.
Medication Adherence
时间窗: Measured weekly throughout study participation, averaged over study participation
5-point scale (1 = best adherence, 5= nonadherent) based on pill counts, MEMS cap readings, plasma assays, and psychiatrist judgments for oral risperidone and timing of injections for long-acting injectable risperidone averaged over study participation
Change in Global Functioning Scale: Role
时间窗: Measured at Baseline and Month 12
10-point scale of work/school functioning. Scale range is from 1 (extreme role dysfunction) to 10 (superior role functioning). Measured by subtracting the baseline rating from the rating at 12 months.
次要结局
- Awareness of Illness, as Assessed by the Scale to Assess Unawareness of Mental Disorder-Revised (SUMD-R)(Baseline to 12 months)
- MATRICS Consensus Cognitive Battery (MCCB) Overall Composite T Score(Measured at baseline and 12 months)
- Emotional Reactivity on Psychophysiological Measures(Measured from Baseline to Month 12)
- Retention in Treatment(From baseline to 12 months)
研究者
Keith Nuechterlein, Ph.D.
Professor, University of California, Los Angeles
University of California, Los Angeles
