Psychosis Clinical Trial
— GDROfficial title:
Impact of Guided Antipsychotic Dose Reduction in Patients With Psychosis Under Remitted States: a Randomized Control Trial and Prospective Follow-up Study
A 2-year prospective observational study comparing a group of patients in remitted states of psychosis undergoing guided antipsychotic dose reduction to a similar group of patients under maintenance antipsychotic treatment with the main outcome of interest that if the rates of relapse of psychosis between these two groups will be different.
Status | Recruiting |
Enrollment | 160 |
Est. completion date | December 31, 2020 |
Est. primary completion date | December 31, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 50 Years |
Eligibility |
Inclusion Criteria: 1. A diagnosis of schizophrenia, schizophreniform disorder, psychosis NOS, based on the DSM-5 criteria 2. With a Positive and Negative Syndrome Scale (PANSS), score < 3 in all 3 positive symptoms (P1: delusion, P2: conceptual disorganization, P3: hallucination) and 2 general symptoms (G9: unusual thought, G5: mannerism and posturing) for at least 3 months 3. With a PANSS score < 4 in all 3 negative symptoms (N1: blunted affect, N4: social withdrawal, N6: lack of spontaneity/flow in conversation) for at least 3 months 4. Currently receiving antipsychotic treatment at a fixed dose for at least 3 months, including long-acting injectable antipsychotic 5. A second antipsychotic agent only used for a low-dose, as needed adjuvant purpose 6. No revised use of benzodiazepines, antidepressants, anticholinergics, or other concomitant medications during past 3 months - Exclusion Criteria: 1. A score of 5 or more on any of the 30 PANSS rating items at screening 2. Admission to acute psychiatric unit during past 6 months 3. A change in dose of current antipsychotic medication in recent 3 months 4. Concomitant use of mood stabilizers, such as lithium, valproic acid or other anti-epileptic drugs 5. Mental retardation known as IQ below 70 prior to the diagnosis of schizophrenia 6. A history of pervasive mental disorder or bipolar disorder 7. A medical condition with significant cognitive sequelae 8. A history of substance dependence during past 6 months 9. Currently in pregnancy or breastfeeding |
Country | Name | City | State |
---|---|---|---|
Taiwan | National Taiwan University Hospital | Taipei |
Lead Sponsor | Collaborator |
---|---|
National Taiwan University Hospital |
Taiwan,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Relapse of psychosis defined by worsening of scores in Positive and Negative Syndrome Scale (PANSS) | Patients will be measured with a Positive and Negative Syndrome Scale (PANSS) every 4 weeks for 3 times (during 12 weeks) if conducting dose reduction or every 12 weeks if staying on the same dose to observe if any worsening of symptoms. Patient has a PANSS score > 4 in any item of those 3 positive symptoms (P1: delusion, P2: conceptual disorganization, P3: hallucination) and 2 general symptoms (G9: unusual thought, G5:mannerism and posturing) during observational period for more than 1 week will be recognized as having a relapse of psychosis. | up to 2 years | |
Secondary | Personal Social Performance (PSP) scores | Patients will be rated by their attending psychiatrists with PSP scale to evaluate their functioning in 4 aspects of life, including socially useful activities, personal and social relationships, self-care, and disturbing and aggressive behaviors as to give a summary score at baseline and annually | up to 2 years | |
Secondary | quality of life (Euro-5D VAS) | Patients report their quality of life using a 20-cm visual analogue at baseline and annually. | up to 2 years | |
Secondary | severity of extrapyramidal symptoms | Patient's severity of extrapyramidal symptoms will be rated by their psychiatrists using Simpson-Angus Scale, the Abnormal Involuntary Movement Scale, and the Barnes Akathisia Rating Scale at each visit. | up to 2 years | |
Secondary | medication satisfaction questionnaire (MSQ) | Patients will be asked to fill a self-rated 7-point Likert scale for medication satisfaction at baseline and annually. | up to 2 years | |
Secondary | neurocognitive functioning | Patients will be assessed with the module for schizophrenia of the Cambridge Neuropsychological Test Automatic Battery (Cantab) at baseline and at the exit of the study. | up to 2 years |
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