Schizophrenia Clinical Trial
Official title:
Double-Blind, Randomized, Placebo-Controlled, Cross-Over Study of Intranasal Oxytocin Augmentation of Antipsychotic Medication in Schizophrenia Patients
The objective of the study is to compare the efficacy of intranasal oxytocin versus intranasal placebo to improve symptoms in schizophrenia patients who have residual symptoms despite being on adequate treatment with antipsychotic medication.
Schizophrenia patients treated with even the best currently available antipsychotic drugs
continue to experience significant symptoms. There is a strong need for better treatments
including treatments that can safely be given as adjunct to current antipsychotics in order
to improve overall efficacy of treatment.
Oxytocin is a neurohypophyseal peptide best known for its role as a neurohormone involved in
parturition and lactation. In addition to these well established peripheral effects, there is
a compelling body of converging evidence indicating that oxytocin plays a critical role in
the regulation of a number of diverse centrally-mediated behavioral and cognitive processes
that are highly relevant to Schizophrenia, including social attachment and memory , (see
Argiolas and Gessa 1990; McCarthy and Aaltemus 1997).Furthermore, several lines of research
suggest that oxytocin receptors may be an important target for development of novel
treatments for schizophrenia. Oxytocin and its receptors exist in several areas of the brain
which have been heavily implicated in the pathophysiology of schizophrenia, such as the
nucleus accumbens and the hippocampus, (Van Leeuwan et al 1985). Oxytocin administered
peripherally inhibits dopamine transmission in the mesolimbic pathway (Sarnyai 1992) et al,
1990). Antipsychotics have been found to elevate the secretion of oxytocin in rats
(Uvnas-Moberg et al 1992a) suggesting that endogenous oxytocin may play a role in the
therapeutic effects of antipsychotic drugs.
Each subject will be enrolled for 6 week treatment period after a screening phase Study
procedure involves weekly clinic visits as an outpatient. Forty patients will be randomly
assigned to either 40 IU oxytocin twice daily or vehicle placebo. After 3 weeks, treatments
will be crossed over such that subjects that received oxytocin will receive placebo and vice
versa. The study ratio is 1:1. Dose of oxytocin is based upon previous studies in humans
showing improvement in schizophrenia related changes in behavior and brain function (Kosfeld
et al, 2005; Kirsch 2005; Heinrich M 2003).
The total study duration for each individual subject will be approximately 7 weeks, which
includes up to 7-day screening period, a baseline (randomization) visit, three week treatment
period, 1 week washout, baseline, and three weeks cross over treatment.
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