High Dose Risperidone Consta for Patients With Schizophrenia With Poor Response to Risperidone

Schizophrenia Clinical Trial

Official title:

High Dose Risperidone Consta for Patients With Schizophrenia With Unsatisfactory Response to Standard Dose Risperidone or Long-Acting Injectable

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00539071
• Other study ID #: 070580
• Status: Completed
• Phase: Phase 4
• Start date: March 2008
• Est. completion date: May 2012

Study information

• Verified date: July 2019
• Source: Northwestern University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to look at two doses of long-acting injectable risperidone (Risperdal Consta). The study will use a usual dose of Risperdal Consta (50 mg given every two weeks) or a higher dose (75 mg-100 mg given every two weeks) to see which one is better at improving symptoms of schizophrenia or schizoaffective disorder.

Description:

This six month double-blind,randomized trial is designed to compare the efficacy of high dose long acting risperidone ( 75 mg-100 mg q2 weeks or its equivalent) with standard doses of long acting risperidone (≤50 mg/q 2weeks) for Total Psychopathology, positive, negative, and depressive symptoms, and cognition in patients who are considered to be poor responders by themselves, significant others, or clinicians. This will include two types of inadequately responding patients—those who are treatment resistant by research criteria (Kane et al., 1988) and those with inadequate response

Recruitment information / eligibility

• Status: Completed
• Enrollment: 160
• Est. completion date: May 2012
• Est. primary completion date: May 2012
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 65 Years

Eligibility

Inclusion Criteria:

• Patients diagnosed with schizophrenia or schizoaffective disorder

• Able to give written informed consent.

• Moderate psychosis persists although compliant with medication

• Patients must have an inadequate response to two antipsychotic medications (can be risperidone, oral or long acting - but not required), at doses that are within the upper end of the standard dosage range

• Patients must have a Clinical Global Impression - Severity (CGI-S) scale score at screening of at least moderate severity and a PSP score of 60 or below.

• At the time of screening, eligible patients will be receiving or have received treatment with risperidone oral or Consta, or a combination that does not exceed 50 mg q 2 weeks of Consta or oral risperidone 8 mg/day for at least 6 weeks within seven years of study entry without satisfactory response as documented in the medical record Risperidone

• Patients who have received Consta injectable medication within the specified dose range for no more than a month prior to the onset of the study will be eligible. Patients receiving mood stabilizers or antidepressants, or both, in addition to risperidone oral or Consta, will be eligible

• Patients may initially be inpatients or outpatients

• Females of child bearing potential will be admitted only if they are on stable birth control medication and understand that they should not get pregnant during the course of the study.

• All patients must have stable housing at the current time or plans for housing following hospital discharge, if an inpatient.

• Patients must be willing to receive injectable medication

Exclusion Criteria:

• Patients with a diagnosis other than schizophrenia or schizoaffective disorder.

• Patients previously treated with doses of these agents higher than those allowed for at least six months and who failed to have an adequate response will be excluded

• Patients currently taking clozapine or have failed an adequate trial of clozapine which lasted at least 3 months

• Pregnant females. Females who are currently breastfeeding will be excluded.

• Patients with a diagnosis of substance dependence at screening or up to one year prior to enrollment.

• Patient with worse than mild tardive dyskinesia or history of marked EPS at screening

• Patients who have had neuroleptic malignant syndrome

• Patients with a history of galactorrhea

• Patients with uncontrolled medical condition(s)

• Patients with a history of non-compliance to oral or injectable medication.

• Patients unwilling to have injectable medication

Related Conditions & MeSH terms

• Psychotic Disorders
• Schizoaffective Disorder
• Schizophrenia

Intervention

Drug:
• long-acting injectable risperidone
Subjects will be randomized to conventional dose Consta or high dose Consta. All of those who are randomized to the conventional Consta dose will receive it in the form of Consta at a starting dose of 50 mg q 2 weeks. Those who are randomized to high dose Consta will receive a Consta 50 mg injection plus 25 mg injection (total dose 75 mg) q 2 weeks as the starting dose.Oral risperidone will be given up to Week 4 along with the injections for both groups to provide a transition phase.At Week 6, psychopathology will be assessed with a PANSS. If no improvement from baseline is shown, the randomized dose of Consta will be increased to 100 mg q 2 weeks (given as two 50 mg injections ) for those in the high dose Consta group. The dose for those randomized to the conventional dose group will remain the same (50 mg plus placebo).
• long acting injectable risperidone
Study dose remains 50 mg for the length of the study.
• long acting injectable risperidone
Beginning dose 75 mg. Can be increased to 100 mg at Week 6.

Locations

Country	Name	City	State
United States	Vanderbilt Psychiatric Hospital	Nashville	Tennessee

Sponsors (2)

Lead Sponsor	Collaborator
Northwestern University	Ortho-McNeil Janssen Scientific Affairs, LLC

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The primary end point will be change in PANSS Positive Subscale Score in the high dose group using a mixed model ANOVA		six months
Secondary	change in PANSS; time to discontinuation for lack of efficacy and tolerability; change in cognitive domain scores; comparative incidence and time course of EPS, hyperprolactinemia, plasma lipids, weight gain, and other side effects between treatments		six months