Schizophrenia Clinical Trial
Official title:
A Trial of the Effects of Glycine Loading on Clinical Symptoms and Logical Memory in Patients With Schizophrenia
The goal of this project is to understand whether glycine is helpful for improving some
symptoms of schizophrenia such as low motivation, loss of interest, and social isolation. In
addition, the investigators want to find out if glycine improves memory.
This project involves a three-and-a-half month trial of glycine or placebo. A placebo looks
exactly like the study drug, but it contains no active drug. Glycine is a naturally
occurring substance that is a part of some of the proteins in your body. Glycine has not
been approved by the FDA (Food and Drug Administration) for the treatment of schizophrenia.
However, the FDA allows it to be used in research studies.
Related Study at McLean Hospital: If you would like to participate in this study of glycine
versus placebo at the Freedom Trail Clinic, the investigators will ask you if you would also
like to participate in a related study at McLean Hospital. The study at McLean Hospital will
look at the effects of glycine and placebo on levels of glycine in the brain. The study will
use magnetic resonance spectroscopy to measure brain glycine levels. The magnetic resonance
(MR) scanner looks like a large cylinder with a tube running down the center. You will be
asked to lie down on your back on a foam-padded table and place your head into a special
holder. The table will slide you inside the "hole" of the scanner. Soft foam rubber sponges
may be placed on both sides of your head for comfort and to help keep your head from moving.
Because the scanner contains a strong magnet, you will be asked to remove all metal objects
from your person including, but not limited to: watches, rings, necklaces, bracelets,
earrings and other body piercings, belts, loose change, wallet (with credit cards), items of
clothing containing magnetic materials (for example, underwire bras, certain types of
zippers), and shoes. These items will be secured in a safe place until your scan is
completed. You will be able to remain in your street clothes. The investigators will ask you
if study staff from McLean Hospital can contact you to tell you more about the study. You
may refuse to be contacted by McLean Hospital. However, if you do not participate in the
study at McLean, you are not eligible for the study here at the Freedom Trail Clinic.
If you agree to participate in this study, you will be taking glycine or a placebo for 12
weeks - in two 6-week periods. These two 6-week periods are separated by a 2-week "wash-out"
period where you take no study medication. During one of the 6-week periods, you will be
taking glycine. During the other 6-week period, you will be taking placebo. Neither you nor
the study staff will know in which order you receive the glycine or placebo. In case of an
emergency, we can quickly find out which medication you have been taking.
If you agree to participate in this study, we will then meet for a "screening visit" to see
if you are eligible for participation in the study. You will have an interview where you
will be asked about your history of psychiatric illness. We will also ask about your
previous history with smoking and use of other drugs and about your current medications. We
will ask you to sign an authorization form so that we can look at your medical record. We
will review your medical record for medical and psychiatric diagnoses and treatment. We will
check your heart rate and blood pressure. We will take a saliva (spit) sample to check for
use of street drugs such as alcohol, cocaine, amphetamines, opiates, and marijuana. If you
test positive for the presence of any of these substances, you will not be allowed to
participate in the study. Information about drug use will not become a part of your medical
record, but this information will become a part of your research record.
After you have completed this screening interview, we will arrange a date and time for you
to come back for an initial assessment before the start the study. The initial assessment
takes about an hour and a half. During this assessment we will ask you questions about
different psychiatric symptoms that you may be having. You will be asked about your
thinking, mood, unusual experiences such as hearing voices, side effects from antipsychotic
medications, and smoking behavior.
You will have the carbon monoxide in your breath measured. Carbon monoxide is a gas
contained in cigarette smoke, and measuring the level of carbon monoxide in your breath
helps us to tell whether or not you smoke cigarettes. To measure your carbon monoxide, we
will have you breathe into a small hand-held machine.
We will also ask you about your regular activities during the day and what kind of
hobbies/interests you have. Then you will do a memory test where the interviewer will tell
you a story and ask you to repeat it back to him.
After you have completed the initial assessment, you will begin taking the study medication.
The study medication is glycine or identical placebo and is in the form of a liquid. A
one-week supply of the medication will be given to you on your weekly visit to McLean
Hospital. You will take one dose of medication with breakfast in the morning and the second
dose of medication with dinner in the evening. You should keep the study medication
refrigerated. You will take approximately 30 grams (about 1 quarter of a liter) twice per
day for the first 6 weeks, but the exact amount that you will take will depend upon your
weight. We will instruct you in exactly how much to take.
At the end of the first 6 weeks of the study, you will stop taking the glycine or identical
placebo for 2 weeks. During the 2 weeks where you take no study medication, we will arrange
for you to come in for a brief check in visit (at week 7) to ask about any side effects
after you have stopped taking the medication.
After two weeks of taking no medication, you will again start taking glycine or placebo for
the next 6 weeks.
You will not change your regular medications during the study. You are to continue taking
all your other medications throughout the study. You should notify Dr. Evins or any of the
research staff if you start to take any new medications. You will come in every week to pick
up your study medications.
We ask you to come for an interview and a test of your memory four times throughout the
study. The first time is the initial visit described above, before you have started taking
the study medication.
The other assessments will take place 6 weeks into the study (at the end of your first
6-week period on study medication), 8 weeks into the study (after the 2-week "washout"
period when you will have been taking no study medication), and 14 weeks into the study (at
the end of your second 6-week period on study medication).
There will be a total of 4 blood draws that will occur on 4 separate occasions. The blood
draws will take place on the same days as the scanning visits at McLean Hospital. At each
blood draw, we will take about 1 tablespoon of blood. The total amount of blood we will take
in the study is about 4 tablespoons.
The study will last 14 weeks. At the end of the study, you will stop taking all glycine or
placebo. If you or your doctor believes that glycine has been helpful to you and you wish to
take it once the study has ended, it is available through some pharmacies, and you should
discuss this option with your doctor or psychiatrist.
We will ask you to attend one follow-up visit a week after the end of the study, when we
will ask you about any side effects you may have experienced. We will also ask you about
side effects throughout the course of the study. This follow-up visit would last about 15
minutes.
;
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Basic Science
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