Omega-3 Fatty Acid Adjunctive to Open-Label Aripiprazole for the Treatment of Bipolar Disorder in Children and Adolescents
Information source: Massachusetts General Hospital
ClinicalTrials.gov processed this data on August 20, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Pediatric Bipolar Disorder
Intervention: Aripiprazole (Drug); fish oil (Dietary Supplement); Placebo (Drug)
Phase: Phase 4
Status: Terminated
Sponsored by: Massachusetts General Hospital Official(s) and/or principal investigator(s): Janet Wozniak, MD, Principal Investigator, Affiliation: Massachusetts General Hospital
Summary
This will be a 12 week, double blind study of omega-3 fatty acids vs. placebo adjunctive to
open-label aripiprazole treatment in children and adolescents (ages 6-17) who meet DSM-IV
criteria for bipolar disorder (BPD) (currently manic or mixed). Specific hypotheses are as
follows:
Hypothesis 1: Omega-3 fatty acids will be well-tolerated and efficacious in the treatment of
children and adolescents with BPD
Hypothesis 2: The total dose of aripiprazole will be lower in those subjects receiving
active omega-3 treatment
Clinical Details
Official title: A Randomized Placebo Controlled Clinical Trial of Omega-3 Fatty Acid Adjunctive to Open-Label Aripiprazole for the Treatment of Bipolar Disorder in Children and Adolescents Ages 6-17 With Bipolar Spectrum Disorder
Study design: Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
Primary outcome: Change in Bipolar Symptoms as Assessed by Young-Mania Rating Scale (YMRS)
Secondary outcome: DSM-IV Mania Symptom Checklist
Detailed description:
Initial clinical evidence suggests that the omega-3 fatty acids EPA (eicosapentaenoic acid)
and/or DHA (docosahexaenoic acid) may play a therapeutic role in the management of mood
disorders. EPA is an essential fatty acid, which can be metabolized to DHA and is a
component of the human diet if fish is consumed. Aripiprazole is a novel second general
antipsychotic that seems to function as a partial agonist at the dopamine D2 and serotonin
5-HT 1A receptors as well as an antagonist at the serotonin 5-HT 2A receptor. Since it has
a favorable adverse event profile in adults, it is an attractive choice for the treatment of
youth with bipolar disorder if proven efficacious. Although pilot research showed that
omega-3 fatty acids monotherapy treatment resulted in improvement of manic symptoms, the
improvement is less dramatic than that observed in trials of antipsychotics. We will test
the safety and efficacy of omega-3 fatty acids versus placebo as an adjunctive treatment to
open-label aripiprazole in children and adolescents with bipolar disorder.
The proposed study includes 1) the use of a 12-week design to document the response rate 2)
careful assessment of safety and tolerability
Eligibility
Minimum age: 6 Years.
Maximum age: 17 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
1. Male or female subject, 6-17 years of age
2. Subject has a DSM-IV diagnosis of bipolar I, bipolar II, or bipolar spectrum disorder
and currently displaying manic, hypomanic, or mixed symptoms (with or without
psychotic features)
3. Subject and their legal representative have a level of understanding sufficient to
communicate intelligently with the investigator and study coordinator, and to
cooperate with all tests and examinations required by the protocol
4. Subject and their legal representative must be considered reliable
5. Subject and his/her authorized legal representative must understand the nature of the
study. The subject's authorized legal representative must sign an informed consent
document and the subject must sign an informed assent document
6. Subject must have an initial score on the Young-Mania Rating Scale (Y-MRS) of at
least 20
7. Subject must be able to participate in mandatory blood draws
8. Subject must be able to swallow pills
9. Subjects with comorbid Attention Deficit Hyperactivity Disorder (ADHD), Oppositional
Defiant Disorder (ODD), Conduct Disorder (CD), Obsessive Compulsive Disorder (OCD),
Pervasive Developmental Disorders (PDD), anxiety and depressive disorders will be
allowed to participate in the study provided they do not meet for any of exclusionary
criteria
10. For concomitant therapy used to treat ADHD, subject must have been on a stable dose
of the medication for 1 month prior to study enrollment. The dose of the ADHD
therapy may not change throughout the duration of the study.
Exclusion Criteria:
1. Investigator and his/her immediate family; defined as the investigator's spouse,
parent, child, grandparent, or grandchild
2. Serious, unstable illness including heptic, renal, gastroenterological, respiratory,
cardiovascular (including ischemic heart disease), endocrinologic, neurologic,
immunologic, or hematologic disease
3. Uncorrected hypothyroidism or hyperthyroidism
4. History of sensitivity to omega-3 fatty acids. A non-responder or history of
intolerance to omega-3 fatty acid, after treatment at adequate doses as determined by
the clinician.
5. Severe allergies or multiple adverse drug reactions.
6. Non-febrile seizures without a clear and resolved etiology
7. DSM-IV substance (except nicotine or caffeine) dependence within past 6 months
8. Judged clinically to be at serious suicidal risk
9. Any other concomitant medication with primarily central nervous system activity other
than specified in the Concomitant Medication portion of the protocol.
10. Current diagnosis of schizophrenia
11. Pregnant or nursing females
Locations and Contacts
Massachusetts General Hospital, Cambridge, Massachusetts 02138, United States
Additional Information
Starting date: December 2007
Last updated: March 9, 2012
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