In this study, investigators will evaluate the efficacy and related mechanism of probiotics and prebiotics as an add-on treatment in improving the antipsychotic induced psychotic syndrome, the cognitive impairment, gastrointestinal function, and metabolic disorders in schizophrenia patients, through genotype identification, psychopathology, neuropsychology, biochemical evaluation and other methods.
The study will recruit 210 schizophrenia patients who meet the criteria of DSM-4, and then randomized to 3 groups: control group, probiotics group and prebiotics group for a 14-weeks clinical trail and 12-weeks follow-up period. In addition to probiotics, prebiotic or maltodextrin interventions, in the meantime, all participants will also use one of the prescribed antipsychotics medications. Clinical efficacy and safety assessment will be done at baseline, clinical trail and follow-up period. The specific aims are to evaluate these tips: 1) psychotic syndrome; 2) cognition; 3) Gastrointestinal function; 4) inflammatory and metabolic related markers. Psychotic syndrome will be measured by the Positive and Negative Syndrome Scale. Cognitive function will be assessed by the MATRICS Consensus Cognitive Battery. Gastrointestinal function will be assessed by gastrointestinal symptom assessment scale (GSRS). Biological samples also will be collected, and stored to research Intestinal inflammation, intestinal permeability, intestinal flora and other indicators.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
200
The probiotic compound will consist of tables containing approximately 10\^9 colony forming units of the probiotic organisms, Lactobacillus and Bifidobacteria lactis strain,mixed maltodextrin(oral, daily for 14 weeks).
The prebiotic compound will consist of tables containing inulin and maltodextrin (oral,daily for 14 weeks)
Maltodextrin tables (oral,daily for 14 weeks)
First Affiliated Hospital of Xi'an Jiao tong University
Xi’an, Shanxi, China
RECRUITINGChange in Positive and Negative Syndrome Scale (PANSS) Score from week0 to week26
The complete PANSS contains ratings for 30 symptoms, including 7 positive symptoms, 7 negative symptoms, and 16 general psychiatric symptoms. The clinical efficacy was evaluated by its score reduction rate, with the total score reduction rate ≥75% as recovery, 50% \~ 74% as significant improvement, 25% \~ 49% as improvement, and \<25% as invalid. improvement, significant improvement and recovery add up to apparent effect.
Time frame: 26weeks(week0 to week26)
Change in MATRICS Consensus Cognitive Battery(MCCB) Score from week1 to week26
Change in the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) score from the start of Trial period to the end of the follow-up phase; Cognitive performance is measured by the MATRICS Consensus Cognitive Battery composite score in participants.
Time frame: week26(week1 to week26 )
Gastrointestinal symptom rating scale (GSRS)
Gastrointestinal function will be assessed during the screening stage,week 4, week 8, week 12, week 14 of treatment stage and once every 4 weeks of follow-up stage through Gastrointestinal symptom rating scale (GSRS); The score reduction of GSRS≥25% was associated with improvement in gastrointestinal function.
Time frame: week26 (week1 to week26)
Serum inflammatory factors-TH-1
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --TH-1
Time frame: week26(week1 to week26)
Serum inflammatory factors-TH-2
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines--TH-2
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Time frame: week26(week1 to week26)
Serum inflammatory factors-TH-17
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines--TH-17
Time frame: week26(week1 to week26)
Serum inflammatory factors-Interleukin-1
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines--Interleukin-1
Time frame: week26(week1 to week26)
Serum inflammatory factors-Interleukin-2
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --Interleukin-2
Time frame: week26(week1 to week26)
Serum inflammatory factors-Interleukin-6
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --Interleukin-6
Time frame: week26(week1 to week26)
Serum inflammatory factors-Interleukin-10
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --Interleukin-10
Time frame: week26(week1 to week26)
Serum inflammatory factors-Interleukin-17
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --Interleukin-17
Time frame: week26(week1 to week26)
Serum inflammatory factors-TNF-a
Change of intestinal inflammation will be assessed during the the double-blind phase, including serum inflammatory cytokines --TNF-a(tumor necrosis factor-a,interferon).
Time frame: week26(week1 to week26)
Fecal intestinal flora
The number of lactobacillus and bifidobacterium flora will be assessed; The species and abundance of intestinal flora were identified by 16SrRNA.
Time frame: week26 (week1 to week26)
Serum intestinal permeability index-FABP2
Change of Serum intestinal permeability index will be assessed during the the double-blind phase- FABP2
Time frame: week26(week1 to week26)
Serum intestinal permeability index-sCD14
Change of Serum intestinal permeability index will be assessed during the the double-blind phase-sCD14
Time frame: week26(week1 to week26)
Serum intestinal permeability index-LBP
Change of Serum intestinal permeability index will be assessed during the the double-blind phase-LBP
Time frame: week26(week1 to week26)