Schizophrenia Clinical Trial
Official title:
Independent Investigator Grant Study-Comparative Effects of Chronic Treatment With Olanzapine and Risperidone on Glucose and Lipid Metabolism
The primary objective of the study is to assess whether chronic treatment with olanzapine
over a five-month period produces a significant increase in abnormalities in glucose levels.
The main secondary objective is to evaluate whether the increase in glucose levels and rate
of glucose abnormalities differs between Olanzapine and Risperidone during this treatment
period. Additional secondary objectives of the study are to investigate similar questions
with respect to glycohemoglobin, triglycerides and other measures of glucose and lipid
metabolism.
We hypothesize that Olanzapine will not be inferior to Risperidone in extent of increase in
the primary outcome measure of serum glucose, and secondary measures of glycohemoglobin,
insulin and lipids.
In the on-going study in progress we use an extensive battery of assessments to investigate
a)fasting levels of glucose and lipids at baseline and monthly during 5 months of treatment,
b) glucose tolerance tests to investigate glucose and insulin abnormalities after a glucose
load at baseline and during study treatment, and c)the effects of treatment with olanzapine
and risperidone of post prandial glucose metabolism after a fatty meal (as detailed in the
body of the proposal). Recent studies have shown that increased postprandial lipidemia is an
important feature of many patients with type 2 diabetes and atherosclerosis. In addition to
the biochemical measures, we will also assess clinical effects (PANSS and CGI ratings) and
other side-effects (weight gain, appetite, somnolence, and EPS and TD). The specific plan
calls for inpatients in a tertiary care hospital to be randomly assigned to olanzapine or
risperidone, using a stratified random assignment procedure, and treated for five months
with either olanzapine or risperidone. We estimate that we will have to enroll a sample of
approximately 50-55 patients to obtain 46 acceptable complete cases(as specified in proposal
below). On the basis of preliminary results from our prior and ongoing studies we predict no
significant increase in glucose abnormalities from baseline during chronic treatment with
olanzapine and no significant differences in development of glucose abnormalities in
patients in patient treated with olanzapine and risperidone.
Additional measures being investigated include: comparison of olanzapine and risperidone in
glucose and lipid responses to a fatty meal, ghrelin changes in response to a fatty mean,
and CRP and IL-6, and thyroid and prolactin response to five months of treatment with the
two drugs.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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