Weight Gain Clinical Trial
Official title:
Improving Metabolic Parameters of Antipsychotic Child Treatment With Ziprasidone, Aripiprazole, and Clozapine
The purpose of this study is to evaluate the relative risks and benefits of two approaches
to the control of weight gain and other negative side effects in children and adolescents on
2nd generation antipsychotics (SGA):
- Healthy lifestyle instruction (nutritional and physical activity surveillance and
advice) + continuation of current SGA;
- Add the diabetes drug, metformin + continuation of current SGA.
The proposed pilot study is being conducted to obtain pilot data to support a grant
application for a multi-site randomized controlled trial. The primary objective is to
evaluate the relative risks and benefits of two approaches to the control of weight gain and
other negative side effects in children and adolescents on 2nd generation antipsychotics
(SGA). The critical question being addressed is: What can be done for the many youth who
have gained substantial weight or developed high levels of lipids or glucose in their blood
on an SGA; but due to their illness require continued treatment with an antipsychotic?
At least 40 youths (and no more than 60) age 10-17 that have gained substantial weight while
taking a frequently used SGA: ziprasidone, aripiprazole or clozapine will be randomized to
one of two treatments for 6 months:
- Healthy lifestyle instruction (nutritional and physical activity surveillance and
advice) + continuation of current SGA;
- Add the diabetes drug, metformin + continuation of current SGA.
- Subjects may also elect to be in an observational arm that involves no intervention but
the same major assessments.
Height, weight, body fat, and various blood tests indicative of general health will be
collected during the 6 month trial to monitor the health benefits and safety of the
interventions.
SGAs are associated with concerning degrees of weight gain and metabolic consequences.
Children and adolescents, in whom SGAs are used increasingly for a wide variety of
conditions, are particularly vulnerable to these side effects, which adversely affect health
and longevity. It is imperative that researchers evaluate the efficacy and safety of
interventions designed to prevent and treat the weight gain and metabolic problems caused by
antipsychotic treatment of children. Lifestyle interventions and adjunctive medications all
hold some promise of efficacy. However, it is essential that these strategies be rigorously
evaluated as soon as possible in order to prevent the ongoing health consequences of SGA
treatment in another generation of children with serious psychiatric illnesses.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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