This study is designed to find out whether taking antipsychotic medication once every two weeks by injection compared to taking daily oral medication will help people with schizophrenia maintain better control of their symptoms.
As is the case with many chronic illnesses, it can be challenging for people with schizophrenia to take multiple pills every day on a long-term basis. At the same time, missing or discontinuing the anti-psychotic medications that treat schizophrenia substantially increases the risk of relapse and re-hospitalization. This study will determine how effective long-acting injectable risperidone is compared to oral antipsychotic medications to help patients who have schizophrenia. Patients who enroll in the study will be randomly assigned to receive either long-acting injectable risperidone or to receive oral "atypical" antipsychotic medication. The "atypical" antipsychotics that are included for patients in the oral group are: aripiprazole, olanzapine, quetiapine, risperidone, and ziprasidone. Patients in the "oral" group will receive whichever of the five "atypical" antipsychotic medications they and their study doctor decide is best for them. Patients in the "oral" group will be allowed to switch to others of the five medications during the study if they and their doctor think that is best. Patients in this study will be evaluated at the beginning of the study and then again every two weeks for up to 30 months (2 1/2 years). Each two-week visit will take about 20 minutes. At the visit, patients will receive medication and will be examined for side effects of the medications, their vital signs (heart rate, blood pressure, weight, and waist measurement) will be measured, and they will be asked a few questions about attendance at visits and taking medication. The visit that occurs every three months will take about one hour, instead of 20 minutes, and will include additional questions, an examination for muscle stiffness or abnormal body movements, and an interview from a member of the research team conducted using computer technology. In addition, blood and urine samples may be collected about seven times throughout the 30 months of the study treatment. Patients who enroll in this study after the halfway point of the study, may not receive a full 30 months of treatment, but it is planned that all patients will have the opportunity to receive no less than 18 months of treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
357
Minimum dose is 12.5 mg every 2 weeks. Maximum dose is 75 mg every 2 weeks.
Target dose is 4 mg/day.
Target dose is 15 mg/day.
University of California, Los Angeles
Los Angeles, California, United States
Medical College of Georgia, Department of Psychiatry
Augusta, Georgia, United States
University of Iowa College of Medicine, Psychiatry Research
Iowa City, Iowa, United States
Substantial Clinical Deterioration Measured by Psychotic Symptoms
Brief Psychiatric Rating Scale (BPRS) psychosis cluster. Score range is based on the score range for individual items rather than the factor total because is factors have different numbers of items. Score range is 1 -7 where 1 + no symptomatology and 7 = very severe symptoms.
Time frame: Measured throughout study up to 30 months
Number of Patients Discontinuing From the Study
Time frame: Measured throughout study up to 30 months
Number of Days in Hospital
Time frame: Measured throughout study up to 30 months
Control of Psychiatric Symptoms
Brief Psychiatric Rating Scale (BPRS) total score
Time frame: Measured throughout study up to 30 months
Quality of Life Measures
Scale of Functioning (SOF)
Time frame: Measured throughout study up to 30 months
Side Effects and Metabolic Measures
The highest severity of each of 24 adverse event (AE) that was assessed.over the 30 month study period. The mean severity on a scale of 1 (none) to 4 very severe symptom was recorded at each biweekly visit. Results for each variable are summarized over time so that each subject has a single mean severity rating for each AE. There is no named scale. Each of the side effects measured is named in ways that are clear to medical readers e.g anorexia. The range is 1 none to 4 very severe. Therefore, a higher scale score is worse.
Time frame: Measured throughout study up to 30 months
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Target dose is 600 mg/day.
Target dose is 120 mg/day.
Target dose is 20 mg/day.
Target dose is 6 mg/day.
Harvard Medical School -- Massachusetts General Hospital
Boston, Massachusetts, United States
Harvard Medical School -- Dr. John C. Corrigan Community Mental Health Center
Fall River, Massachusetts, United States
Creighton University
Omaha, Nebraska, United States
University of New Mexico
Albuquerque, New Mexico, United States
The Zucker Hillside Hospital
Glen Oaks, New York, United States