Determining Metabolic Effects of Valproate and Antipsychotic Therapy
Information source: National Institute of Mental Health (NIMH)
ClinicalTrials.gov processed this data on August 20, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Schizophrenia
Intervention: Valproate (Drug); Placebo (Drug)
Phase: N/A
Status: Recruiting
Sponsored by: National Institute of Mental Health (NIMH) Official(s) and/or principal investigator(s): Dan W. Haupt, MD, Principal Investigator, Affiliation: Washington University School of Medicine
Overall contact: Martha J. Hessler, BS, Phone: 314-362-2423, Email: hesslema@psychiatry.wustl.edu
Summary
This study will determine the metabolic processes responsible for high levels of blood
glucose, metabolism disorders, and weight gain in people with schizophrenia who have been
treated with antipsychotic medications in combination with valproate.
Clinical Details
Official title: Metabolic Effects of Valproate and Antipsychotic Therapy
Study design: Allocation: Randomized, Endpoint Classification: Pharmacodynamics Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Treatment
Primary outcome: Oral glucose tolerance test (fsOGTT) and hyperinsulinemic pancreatic clamp
Secondary outcome: Body composition using dual energy x-ray absorptiometry, magnetic resonance scans, and anthropomorphic measurements
Detailed description:
This project aims to study the whole-body metabolic processes responsible for hyperglycemia,
dyslipidemia and increased adiposity in schizophrenia patients treated with antipsychotic
medications in combination with valproate. The project hypothesizes that combined treatment
with valproate and antipsychotic medications will decrease insulin sensitivity at the level
of skeletal muscle, liver and adipose tissue, in comparison to antipsychotic monotherapy.
The decrease in insulin sensitivity is hypothesized to be associated with defects in glucose
and lipid metabolism and increased adiposity
Treatment effects of antipsychotic/valproate combination therapy on different components of
insulin secretion and action, and treatment effects on abdominal versus peripheral
adiposity, are unknown despite the availability of gold-standard methods and the prognostic
significance of these issues. Relevant data are needed to target basic research, to identify
the potential for acute and long-term complications, and to plan therapeutic interventions.
The following specific aims will be addressed in non-diabetic schizophrenia patients treated
with atypical antipsychotics who will be randomized to open label treatment with either
valproate or no adjuvant. Evaluations are performed at baseline and 3 months of treatment.
Eligibility
Minimum age: 18 Years.
Maximum age: 60 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Meets DSM-IV criteria for schizophrenia, any type, treated with the same
antipsychotic for at least 6 months
- No antipsychotic medication dose changes for 1 month, and no other medication changes
for 1 month prior to study entry
Exclusion Criteria:
- Meets DSM-IV criteria for substance abuse within 3 months of study entry
- Involuntary legal status (as per Missouri law)
- Any serious medical disorder that may confound the assessment of relevant biologic
measures or diagnosis, including: significant organ system dysfunction, metabolic
diseases, type 1 or 2 diabetes mellitus, pregnancy, endocrine disease, coagulopathy,
anemia, or acute infection
- Currently taking more than one antipsychotic medication
- Currently taking prescription medications (except certain psychotropic medications as
discussed below), including oral contraceptive pills, any glucose lowering agent,
lipid lowering agent, exogenous testosterone, recombinant human growth hormone, or
any other endocrine agent that might confound substrate metabolism
Locations and Contacts
Martha J. Hessler, BS, Phone: 314-362-2423, Email: hesslema@psychiatry.wustl.edu
Washington University School of Medicine, St. Louis, Missouri 63110, United States; Recruiting Elizabeth T Westerhaus, MA, Phone: 314-747-1134, Email: westerhe@psychiatry.wustl.edu Julie Schweiger, Phone: 314-362-3153, Email: schweigj@psychiatry.wustl.eddu Dan W. Haupt, MD, Principal Investigator
Additional Information
Click here for the Washington University Department of Psychiatry
Related publications: Haupt DW, Newcomer JW. Hyperglycemia and antipsychotic medications. J Clin Psychiatry. 2001;62 Suppl 27:15-26; discussion 40-1. Review.
Starting date: December 2004
Last updated: March 10, 2009
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