Melatonin Metabolism Abnormality in Patients With Schizophrenia or Schizoaffective Disorder Treated With Olanzapine
Information source: Seattle Institute for Biomedical and Clinical Research
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Schizophrenia; Schizoaffective Disorder; Bipolar Disorder; Obesity; Metabolic Syndrome
Intervention: olanzapine and melatonin (Drug)
Phase: N/A
Status: Active, not recruiting
Sponsored by: Seattle Institute for Biomedical and Clinical Research Official(s) and/or principal investigator(s): Nael Kilzieh, M.D., Principal Investigator, Affiliation: VA Puget Sound Health Care System, Seattle and Tacoma, WA; University of Washington, Dept. of Psychiatry and Behavioral Sciences
Summary
Atypical antipsychotic medications, such as olanzapine, cause metabolic side effects,
including weight gain, extra fat around the middle of the body, high blood sugar, and high
cholesterol. One of the mechanisms by which these medications may cause these effects is by
reducing plasma melatonin. This study is a pilot project to evaluate 1) the effect of
olanzapine on melatonin secretion levels and 2) the effect of melatonin on
olanzapine-induced changes in melatonin secretion in patients with schizophrenia,
schizoaffective, or bipolar disorder.
Clinical Details
Official title: Melatonin Metabolism Abnormality in Patients With Schizophrenia or Schizoaffective Disorder Treated With Olanzapine and Melatonin Dose Finding for the Correction of the Metabolic Abnormality
Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Primary outcome: Nocturnal melatonin production as estimated by assay of urinary 6-sulfatoxymelatonin (aMT6s) adjusted for creatinine
Secondary outcome: Metabolic indices including weight, waist and hip measurements, and metabolic tests
Detailed description:
To investigate the relationship between olanzapine, melatonin, and metabolic functioning,
this pilot study is evaluating 20 patients with schizophrenia, schizoaffective disorder, or
bipolar disorder over 15 weeks under three experimental conditions: 1) baseline (two weeks
treatment with already established antipsychotic medication other than olanzapine or
clozapine), 2) six weeks treatment with olanzapine only, and 3) six weeks treatment with
olanzapine and melatonin. Half of the patients will receive 0. 3 mg of oral melatonin and
half will receive 3. 0 mg of melatonin. Nocturnal melatonin production, as estimated by
assay of urinary 6-sulfatoxymelatonin(aMT6s) adjusted for creatinine, will be measured
weekly. In addition, weekly measurements of weight and other metabolic indices, including
waist and hip measurements, fasting glucose, serum insulin, cholesterol, triglycerides, and
leptin will be taken. It is anticipated that there will be an olanzapine-induced decrease
in melatonin production. Furthermore, it is expected that the decrease in melatonin
production associated with olanzapine treatment will be reversed by administration of
melatonin with olanzapine.
Eligibility
Minimum age: 18 Years.
Maximum age: 65 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
1. Age 18-65;
2. DSM-IV-TR diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder;
3. Patients who, in the clinical judgment of the investigator, may benefit from a switch
to olanzapine;
4. Females must be of non-child bearing potential (i. e., surgically sterilized, or at
least one year post-menopausal) or on an appropriate dose of oral/depot
contraceptives or using barrier protection and not breast-feeding. Females must have
a urine pregnancy test at screening;
5. Willingness and ability to take medications nightly at 10: 00 p. m.; and
6. The subject or his/her legal representative must provide informed, written consent.
Exclusion Criteria:
1. Females who are pregnant or lactating;
2. Concurrent participation or participation within the prior 30 days in any study
involving investigational medications;
3. Current (within the prior 30 days) diagnosis of substance abuse or dependence;
4. Use of olanzapine within the prior three months;
5. History of allergy or intolerable side-effects to olanzapine in the past;
6. History of significant head trauma, defined as head trauma resulting in loss of
consciousness for more than five minutes and/or neurological or cognitive sequelae;
7. Evidence of any clinically relevant disease (e. g., renal or hepatic impairment,
significant coronary artery disease, cerebrovascular disease, or cancer) or any
clinical finding that in the opinion of the investigator could potentially be
negatively affected by study participation or that could potentially affect study
participation is criterion for exclusion from the study;
8. Use of fluvoxamine, nifedipine, or warfarin for 30 days prior to Baseline Visit.
Locations and Contacts
VA Puget Sound Health Care System, Tacoma and Seattle, Washington 98493, United States
Additional Information
Related publications: Raskind MA, Burke BL, Crites NJ, Tapp AM, Rasmussen DD. Olanzapine-induced weight gain and increased visceral adiposity is blocked by melatonin replacement therapy in rats. Neuropsychopharmacology. 2007 Feb;32(2):284-8. Epub 2006 May 10.
Starting date: July 2007
Last updated: December 17, 2014
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