This is a 12-week, randomized, double-blinded, placebo-controlled trial of telmisartan 80 mg/day as an adjunctive to clozapine or olanzapine therapy, in 70 schizophrenia subjects to examine telmisartan's effect on glucose metabolism, weight, food intake, resting energy expenditure, and body composition. In addition, the study will examine insulin's effects on psychopathology and cognition. Potential subjects will be identified by their clinicians at the Freedom Trail Clinic, or Massachusetts General Hospital. Approximately 70 subjects will be enrolled.
The specific aims include: Primary Aims: 1. Examine the efficacy of telmisartan added to regular doses of clozapine or olanzapine in improving insulin resistance. 2. Examine the efficacy of telmisartan in reducing fasting triglycerides. Secondary Aims: 1. Examine the effects of telmisartan on negative symptoms, positive symptoms, and cognitive function. 2. Examine telmisartan's effects on lipids, body composition, and waist/hip ratio. 3. Examine telmisartan's effects on inflammatory biomarkers including C-reactive protein (CRP) and interleukin 6 (IL-6).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
66
Telmisartan 40mg/day for the first 2 weeks. Telmisartan 80mg/day for the next 10 weeks.
Placebo (plus existing clozapine or olanzapine treatment) for 12 weeks.
Clozapine (plus telmisartan or placebo) for 12 weeks.
Olanzapine (plus telmisartan or placebo) for 12 weeks.
University of Massachusetts Medical School
Worcester, Massachusetts, United States
Insulin Resistance
Insulin resistance as estimated by homeostasis model of assessment of insulin resistance (HOMA-IR) at week 12 in both the experimental and placebo arm. Insulin resistance is a condition in which cells fail to respond to the normal action of the hormone in the body. The HOMA-IR is calculated using a subject's fasting plasma insulin and glucose levels. The higher the score, the higher the level of insulin resistance.
Time frame: 12 weeks
Triglycerides
Fasting triglycerides assessed in both experimental and placebo arm at week 12.
Time frame: 12 weeks
Lipid Metabolism - LDL-cholesterol and HDL-cholesterol
Lipid metabolism - fasting low density lipoprotein (LDL) and high density lipoprotein (HDL) are estimated in both experimental and placebo arms at 12 weeks.
Time frame: 12 weeks
Psychopathology - PANSS Total, PANSS - Negative Score, PANNS - Positive Score and SANS - Total Scores.
The Positive and Negative Syndrome Scale (PANSS) and Scale for the Assessment of Negative Symptoms (SANS) were used to assess the positive and negative symptoms in experimental and placebo arms at 12 weeks. The PANSS total scale includes positive and negative subscales. For both subscales, the score ranges from 7-49 and total PANSS score ranges from 30-210. The total scale is a summation of all the subscales. The SANS score ranges from 0-100. For all scales, a greater score represents a worse outcome.
Time frame: 12 weeks
Body Composition: Waist to Hip Ratio
Body composition as estimated by waist to hip ratio in both experimental and placebo arms at 12 weeks.
Time frame: 12 weeks
Body Composition: Percent Total Body Fat
Body composition estimated by percent total body fat as measured by a dual energy absorptiometry (DXA) scan in both experimental and placebo arms at 12 weeks.
Time frame: 12 weeks
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