- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03149107
"Multimodal Prevention of Psychosis - Investigating Efficacy of N-Acetylcysteine and Psychotherapy in CHR-Patients" (ESPRIT-B1)
Multimodal Prevention of First Psychotic Episode - a 2x2-Factorial Randomized Trial Investigating the Efficacy of Acetylcysteine and Integrated Preventive Psychological Intervention in Subjects Clinically at High Risk for Psychosis
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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Berlin, Germany, 10117
- Charite Berlin
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Berlin, Germany, 10967
- Berlin Vivantes
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Baden-Württemberg
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Mannheim, Baden-Württemberg, Germany, 68159
- Zentralinstitut für Gesundheit Mannheim
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Tübingen, Baden-Württemberg, Germany, 72076
- Universitatsklinik Tubingen
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Bayern
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München, Bayern, Germany, 80336
- LMU Klinikum München
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Nordrhein-Westfalen
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Aachen, Nordrhein-Westfalen, Germany, 52074
- Uniklinik Aachen
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Bonn, Nordrhein-Westfalen, Germany, 53127
- Uniklinikum Bonn
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Düsseldorf, Nordrhein-Westfalen, Germany, 40225
- LVR Klinik Düsseldorf
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Köln, Nordrhein-Westfalen, Germany, 50937
- Uniklinik Köln
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Rheinland-Pfalz
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Alzey, Rheinland-Pfalz, Germany, 55232
- Rheinhessen Fachklinik Alzey
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18 - 40 years;
- Subjects with the ability to follow study instructions and likely to attend and complete all required visits;
- Written informed consent of the subject;
Subjects are able to speak, write and understand the German language sufficiently well (at the investigators discretion) to complete all required study procedures;
Specific inclusion criterion:
- Clinical High Risk Criteria : ESPRIT Ultra-high risk criteria (Attenuated Positive Symptoms and/or Brief Llimited Intermittend Psychotic Symptoms and/or a combination of familial risk or schizotypal disorder with a significant loss of functioning; severity assessed by the Structured Interview for Prodromal Syndromes, SIPS 5.0) and/or The Basic Symptom Criterion 'Cognitive Disturbances, COGDIS' (2/9 cognitive-perceptive basic symptoms; assessed by the Schizophrenia Proneness Instrument - Adult Version, SPI-A)
Exclusion Criteria:
- Known history of hypersensitivity to the investigational drug or to drugs with a similar chemical structure;
- Simultaneously participation in another clinical trial involving administration of an investigational medicinal product within 30 days prior to clinical trial beginning. The simultaneous participation in a noninterventional clinical trial is permitted in case the subject is nevertheless able and willing to attend and complete all required visits and in case there are no other contraindications;
- Subjects with a physical or psychiatric condition which at the investigator's discretion may put the subject at other clinically significant risks than those that are defined as outcome of this study (development of a first psychotic episode, functional deterioration), may confound the trial results, or may interfere with the subject's per protocol participation in this clinical trial;
- Acute Suicidality;
- Known substance abuse or dependence according to DSM-IV-TR;
- Patients with hepatic or renal failure, or with known problems of galactose intolerance, clinically significant lactase deficiency or glucose-galactose malabsorption or histamine-intolerance;
- Subjects with known asthma bronchiale;
- Subjects with a history of gastrointestinal ulcer;
- Intake of antitussives (cough-relieving agents);
- Intake of nitroglycerin
- Exclusion criteria regarding special restrictions for females: Current pregnancy or pregnancy planned within 9 months after start of medication or nursing women and
Females of childbearing potential, who are not using and not willing to use medically reliable methods of contraception for the entire study duration (such as oral, injectable, or implantable contraceptives, or intrauterine contraceptive devices) unless they are surgically sterilized / hysterectomized or there are any other criteria considered sufficiently reliable by the investigator in individual cases.
Indication specific exclusion criteria:
- Having had a psychotic episode for > 1 week (according to SIPS 5.0);
- Having symptoms relevant for inclusion potentially arising from a known general medical disorder;
- Life time antipsychotic medication for more than 30 days (cumulative number of days) at or above minimum dosage of the '1st episode psychosis' range of DGPPN S3 Guidelines (Exception: maximum dosage for aripiprazole 5 mg/d) (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde, 2006);
- Any intake of antipsychotic medication (i.e., independent of duration of intake) within the past 3 months before psychopathological baseline assessments (including self-ratings and screening assessments) at or above minimum dosage of the '1st episode psychosis' range of DGPPN S3 Guidelines (Exception: maximum dosage for aripiprazole 5 mg/d) (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde, 2006);
- Any intake of mood stabilizers (lithium, valproate, carbamazepine, oxcabazepine, lamotrigine) > 30 days (cumulative number of days) during the past three months or any intake during the month before psychopathological baseline assessments;
- Intake of antidepressants during the past 30 days before psychopathological baseline assessments;
- Intake of benzodiazepines for more than 2 consecutive days during the past 5 days before psychopathological baseline assessments;
- Psychotherapeutic intervention during the past 30 days before psychopathological baseline assessments;
- Any past psychotherapeutic treatment targeting specifically psychotic symptoms or its prevention.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: IPPI + NAC
IPPI (Integrated Preventive Psychological Intervention): 21 sessions, the first 20 sessions are scheduled weekly, the last session two weeks after session 20. Single blinded (statistician & rater). N-Acetylcysteine (2000 mg/d, 1000 mg in the morning/evening, oral intake). Will be applied continously over 26 weeks parallel to the psychological intervention. Double-blinded. |
N-Acetylcysteine (2000 mg/d, 1000 mg in the morning/evening, oral intake).
Will be applied continously over 26 weeks parallel to the psychological intervention (IPPI or PSM).
Other Names:
IPPI (Integrated Preventive Psychological Intervention): 21 sessions, the first 20 sessions are scheduled weekly, the last session two weeks after session 20.
Single blinded (statistician & rater)
|
Experimental: PSM + NAC
PSM (Psychological stress management): 11 sessions; the first 10 sessions will be offered biweekly, the last one 2 weeks after session 10. Single blinded (statistician & rater). N-Acetylcysteine (2000 mg/d, 1000 mg in the morning/evening, oral intake). Will be applied continously over 26 weeks parallel to the psychological intervention. Double-blinded. |
N-Acetylcysteine (2000 mg/d, 1000 mg in the morning/evening, oral intake).
Will be applied continously over 26 weeks parallel to the psychological intervention (IPPI or PSM).
Other Names:
PSM (Psychological stress management): 11 sessions; the first 10 sessions will be offered biweekly, the last one 2 weeks after session 10.
Single blinded (statistician & rater).
|
Experimental: IPPI + Placebo
IPPI (Integrated Preventive Psychological Intervention): 21 sessions, the first 20 sessions are scheduled weekly, the last session two weeks after session 20. Single blinded (statistician & rater). Placebo will be applied continously over 26 weeks (oral intake of capsules) parallel to the psychological intervention (IPPI or PSM). |
IPPI (Integrated Preventive Psychological Intervention): 21 sessions, the first 20 sessions are scheduled weekly, the last session two weeks after session 20.
Single blinded (statistician & rater)
Will be applied continously over 26 weeks (oral intake of capsules) parallel to the psychological intervention (IPPI or PSM).
|
Active Comparator: PSM + Placebo
PSM (Psychological stress management): 11 sessions; the first 10 sessions will be offered biweekly, the last one 2 weeks after session 10. Single blinded (statistician & rater). N-Acetylcysteine (2000 mg/d, 1000 mg in the morning/evening, oral intake). Placebo will be applied continously over 26 weeks (oral intake of capsules) parallel to the psychological intervention (IPPI or PSM). |
PSM (Psychological stress management): 11 sessions; the first 10 sessions will be offered biweekly, the last one 2 weeks after session 10.
Single blinded (statistician & rater).
Will be applied continously over 26 weeks (oral intake of capsules) parallel to the psychological intervention (IPPI or PSM).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Transition to psychosis
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Transition to psychosis within 18 months, defined (according to EPOS1) as the presence of at least one psychotic symptom for at least one week (assessed by the SIPS).
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Psychosocial functioning
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Psychosocial functioning assessed by the SOFAS and the FROGS
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Symptom remission
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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1. Remission of symptomatic clinical high risk (CHR) criteria (APS/BLIPS and/or COGIDS); decrease of positive, negative and disorganization symptoms (assessed by the SIPS, BNSS score); conceptual disorganization and cognitive basic symptoms (COGDIS, SPI-A); as well as at-risk symptoms according to UHR (SPI-A);
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Depression remission
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Remission of depressive symptoms (measured by CDSS)
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Improvement of social cognition
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Improvement of social cognition (measured by SAT-MC I & II, PoFA)
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Assessment of safety and tolerability
Time Frame: I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Neurologic and general examination (medical history, weight, - adverse events (assessed by UKU SYMPTOM-LIST), Laboratory assessments
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I. After intervention phase (26 weeks after trial start) and II. as follow-up (78 weeks after trial start)
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Collaborators and Investigators
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Schizophrenia Spectrum and Other Psychotic Disorders
- Schizophrenia
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Anti-Infective Agents
- Antiviral Agents
- Protective Agents
- Respiratory System Agents
- Antioxidants
- Antidotes
- Free Radical Scavengers
- Expectorants
- Acetylcysteine
- N-monoacetylcystine
Other Study ID Numbers
- University Hospital, Bonn
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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