- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03883204
Neurocognitive Effectiveness in Treatment of First-episode Non-affective Psychosis: 3-years Follow-up (PAFIP3_nc3Y)
Neurocognitive Effectiveness in Treatment of First-episode Non-affective Psychosis: a Randomized Comparison of Aripiprazole and Risperidone Over 3 Years
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study setting and financial support: data for the present investigation were obtained from an ongoing epidemiological and three-year longitudinal intervention program of first-episode psychosis (PAFIP) conducted at the outpatient clinic and the inpatient unit at the University Hospital Marqués de Valdecilla, Spain. Conforming to international standards for research ethics, this program was approved by the local institutional review board. Patients meeting inclusion criteria and their families provided written informed consent to be included in the PAFIP. The Mental Health Services of Cantabria provided funding for implementing the program. No pharmaceutical company supplied any financial support.
Study design: this is a flexible-dose study of two neuroleptics (Aripiprazole and Risperidone) assigned at aleatory ratio 1:1. Rapid titration schedule (5-day), until optimal dose is reached, is a rule used unless severe side effects occur. At the treating physician's discretion, the dose and type of antipsychotic medication could be changed based on clinical efficacy and the profile of side effects during the follow-up period. Antimuscarinic medication, Lormetazepam and Clonazepam are allowed for clinical reasons. No antimuscarinic agents are administered prophylactically. Antidepressants (Sertraline) and mood stabilizers (lithium) are permitted if clinically needed.
Clinical assessment: the severity scale of the Clinical Global Impression (CGI) scale, the Brief Psychiatric Rating Scale (BPRS), the Scale for the Assessment of Positive symptoms (SAPS), the Scale for the Assessment of Negative symptoms (SANS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Young Mania Rating Scale (YMRS) were used to evaluate symptomatology. To assess general adverse event experiences, the Scale of the Udvalg for Kliniske Undersogelser (UKU), the Simpson-Angus Rating Scale (SARS) and the Barnes Akathisia Scale (BAS) were used. The same trained psychiatrist (BC-F) completed all clinical assessments. These clinical data are described at AZQ2005 study.
Neuropsychological assessment. Cognitive functioning was assessed in patients at 2 points: baseline and 3 years after the initialization of antipsychotic treatment. The cognitive assessment at baseline was carried out at 12 weeks after recruitment because this time is considered optimal for patients' stabilization. The evaluation required approximately 2 h and was carried out in the same day by the same neuropsychologist (R.A.-A and E.G.-R). The neuropsychological battery comprises 9 cognitive domains: information processing speed, motor dexterity, working memory, verbal learning, visuospatial abilities, delayed memory, attention, executive function and theory of mind.
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Locations
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Cantabria
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Santander, Cantabria, Spain, 39008
- University Hospital Marqués de Valdecilla
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients followed in the First Episode Psychosis Clinical Program (PAFIP III) from January 2015 to December 2020.
- Experiencing their first episode of psychosis (First Episode of Psychosis is defined as that psychopathological state in which for the first time and regardless of its duration, the patient has enough severe psychotic symptoms to allow a diagnosis of psychosis, having received no specific psychiatric treatment for him).
- Living in the catchment area (Cantabria).
- No prior treatment with antipsychotic medication or, if previously treated, a total life time of adequate antipsychotic treatment of less than 6 weeks.
- Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for brief psychotic disorder, schizophreniform disorder, schizophrenia, or schizoaffective disorder.
Exclusion Criteria:
- Meeting DSM-IV criteria for drug dependence.
- Meeting DSM-IV criteria for mental retardation.
- Having a history of neurological disease or head injury with loss of consciousness.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Aripiprazole
Oral, dose range 10-30 mg/day, once or twice a day during study duration.
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Initial dose: 10 mg.
Other Names:
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Active Comparator: Risperidone
Oral, dose range 1-6 mg/day, once or twice a day during study duration.
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Initial dose: 2 mg.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Global cognitive index
Time Frame: 3 years
|
In order to calculate a measure of Global Cognitive Functioning (GCF) raw cognitive scores were reversed when appropriate before standardization so they all have the same direction (the higher, the better).
According to previous methodology, the GCF was calculated as T-scores, with raw scores of a healthy comparison sample.
T scores were converted to deficit scores that reflect presence and severity of cognitive impairment.
Deficit scores on all tests were then "averaged" to create the GCF score.
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3 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in information processing speed
Time Frame: 3 years
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Measured by Wechsler Adult Intelligence Scale (WAIS)-III digit symbol subtest (standard total score).
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3 years
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Change in information processing speed
Time Frame: 3 years
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Measured by Trail Making Test (TMT) trail A.
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3 years
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Change in information processing speed
Time Frame: 3 years
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Measured by Continuoys Performace Test (CPT) reaction time.
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3 years
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Change in motor dexterity
Time Frame: 3 years
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Measured by Grooved Pegboard Test (time to complete with dominant hand).
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3 years
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Change in working memory
Time Frame: 3 years
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Measured by WAIS-III letter-number sequencing test (standard total score).
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3 years
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Change in working memory
Time Frame: 3 years
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Measured by WAIS-III digits forward (standard total score).
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3 years
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Change in verbal learning
Time Frame: 3 years
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Measured by the Rey Auditory Verbal Learning Test (RAVLT) (trials 1-5).
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3 years
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Change in visuospatial abilities
Time Frame: 3 years
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Measured by the Rey Complex Figure (RCF) (copy figure).
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3 years
|
Change in delayed memory
Time Frame: 3 years
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Measured by the Rey Auditory Verbal Learning Test (RAVLT) (list recall and list recognition discrimination subscore).
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3 years
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Change in delayed memory
Time Frame: 3 years
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Measured by the Rey Complex Figure (RCF) (delayed recall).
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3 years
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Change in attention
Time Frame: 3 years
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Measured by Continuoys Performace Test (CPT) (discrimination subscores).
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3 years
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Change in executive function
Time Frame: 3 years
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Measured by Trail Making Test (TMT) trail B.
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3 years
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Change in executive function
Time Frame: 3 years
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Measured by Stroop Test (color-word).
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3 years
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Change in executive function
Time Frame: 3 years
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Measured by the Zoo Map Test (first and second conditions).
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3 years
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Change in executive function
Time Frame: 3 years
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Measured by the Tower of London Test (ToL) (total correct and total moves score).
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3 years
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Change in executive function
Time Frame: 3 years
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Measured by FAS Word Fluency and semantic (animal) fluency tests.
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3 years
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Change in theory of mind
Time Frame: 3 years
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Measured by Eyes Task (total correct score).
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3 years
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Benedicto Crespo-Facorro, Professor, University Hospital Marqués de Valdecilla, IDIVAL, Department of Psychiatry, School of Medicine, University of Cantabria, CIBERSAM Centro Investigación Biomédica en Red Salud Mental, Santander, Spain.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
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
- Schizophrenia Spectrum and Other Psychotic Disorders
- Schizophrenia
- Psychotic Disorders
- Mental Disorders
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Antipsychotic Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Serotonin Agents
- Antidepressive Agents
- Dopamine Agonists
- Dopamine Agents
- Serotonin 5-HT1 Receptor Agonists
- Serotonin Receptor Agonists
- Serotonin 5-HT2 Receptor Antagonists
- Serotonin Antagonists
- Dopamine D2 Receptor Antagonists
- Dopamine Antagonists
- Aripiprazole
- Risperidone
Other Study ID Numbers
- ROAC2018_nc3Y
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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