Melatonin Metabolism Abnormality in Patients With Schizophrenia or Schizoaffective Disorder Treated With Olanzapine

Melatonin Metabolism Abnormality in Patients With Schizophrenia or Schizoaffective Disorder Treated With Olanzapine
This study is currently recruiting participants.
Verified on April 2011 by Seattle Institute for Biomedical and Clinical Research

First Received on August 3, 2007.  
Last Updated on April 22, 2011  
History of Changes
Sponsor: Seattle Institute for Biomedical and Clinical Research
Collaborator: Eli Lilly and Company
Information provided by: Seattle Institute for Biomedical and Clinical Research
ClinicalTrials.gov Identifier: NCT00512070
  Purpose

Atypical antipsychotic medications, such as olanzapine, cause metabolic side effects, including weight gain, extra fat around the middle of the body, high blood sugar, and high cholesterol. One of the mechanisms by which these medications may cause these effects is by reducing plasma melatonin. This study is a pilot project to evaluate 1) the effect of olanzapine on melatonin secretion levels and 2) the effect of melatonin on olanzapine-induced changes in melatonin secretion in patients with schizophrenia, schizoaffective, or bipolar disorder.

Condition Intervention
Schizophrenia
Schizoaffective Disorder
Bipolar Disorder
Obesity
Metabolic Syndrome
Drug: olanzapine and melatonin

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Melatonin Metabolism Abnormality in Patients With Schizophrenia or Schizoaffective Disorder Treated With Olanzapine and Melatonin Dose Finding for the Correction of the Metabolic Abnormality

Resource links provided by NLM:

Further study details as provided by Seattle Institute for Biomedical and Clinical Research:

Primary Outcome Measures:

  • Nocturnal melatonin production as estimated by assay of urinary 6-sulfatoxymelatonin (aMT6s) adjusted for creatinine [ Time Frame: 6 and 12 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:

  • Metabolic indices including weight, waist and hip measurements, and metabolic tests [ Time Frame: 6 and 12 weeks ] [ Designated as safety issue: No ]

Estimated Enrollment: 20
Study Start Date: July 2007
Estimated Study Completion Date: June 2012
Estimated Primary Completion Date: June 2012 (Final data collection date for primary outcome measure)

Arms

Assigned Interventions
IIA: Experimental

Intervention: Drug: olanzapine and melatonin
Drug: olanzapine and melatonin

In treatment phase I, all subjects will receive olanzapine, 10-25 mg/day. In treatment phase II, all subjects will receive olanzapine (10-25 mg/day) plus melatonin. Subjects will be randomized at a ratio of 1:1 to receive melatonin, 0.3 mg/day or 3.0 mg/day. Group IIA will receive 0.3mg day melatonin. Group IIB will receive 3.0 mg/day melatonin.
Other Name: Olanzapine (Zyprexa)
IIB: Experimental

Intervention: Drug: olanzapine and melatonin
Drug: olanzapine and melatonin

In treatment phase I, all subjects will receive olanzapine, 10-25 mg/day. In treatment phase II, all subjects will receive olanzapine (10-25 mg/day) plus melatonin. Subjects will be randomized at a ratio of 1:1 to receive melatonin, 0.3 mg/day or 3.0 mg/day. Group IIA will receive 0.3mg day melatonin. Group IIB will receive 3.0 mg/day melatonin.
Other Name: Olanzapine (Zyprexa)

Detailed Description:

To investigate the relationship between olanzapine, melatonin, and metabolic functioning, this pilot study is evaluating 20 patients with schizophrenia, schizoaffective disorder, or bipolar disorder over 15 weeks under three experimental conditions: 1) baseline (two weeks treatment with already established antipsychotic medication other than olanzapine or clozapine), 2) six weeks treatment with olanzapine only, and 3) six weeks treatment with olanzapine and melatonin. Half of the patients will receive 0.3 mg of oral melatonin and half will receive 3.0 mg of melatonin. Nocturnal melatonin production, as estimated by assay of urinary 6-sulfatoxymelatonin(aMT6s) adjusted for creatinine, will be measured weekly. In addition, weekly measurements of weight and other metabolic indices, including waist and hip measurements, fasting glucose, serum insulin, cholesterol, triglycerides, and leptin will be taken. It is anticipated that there will be an olanzapine-induced decrease in melatonin production. Furthermore, it is expected that the decrease in melatonin production associated with olanzapine treatment will be reversed by administration of melatonin with olanzapine.

  Eligibility

Ages Eligible for Study:   18 Years to 65 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Age 18-65;
  2. DSM-IV-TR diagnosis of schizophrenia, schizoaffective disorder, or bipolar disorder;
  3. Patients who, in the clinical judgment of the investigator, may benefit from a switch to olanzapine;
  4. Females must be of non-child bearing potential (i.e., surgically sterilized, or at least one year post-menopausal) or on an appropriate dose of oral/depot contraceptives or using barrier protection and not breast-feeding. Females must have a urine pregnancy test at screening;
  5. Willingness and ability to take medications nightly at 10:00 p.m.; and
  6. The subject or his/her legal representative must provide informed, written consent.

Exclusion Criteria:

  1. Females who are pregnant or lactating;
  2. Concurrent participation or participation within the prior 30 days in any study involving investigational medications;
  3. Current (within the prior 30 days) diagnosis of substance abuse or dependence;
  4. Use of olanzapine within the prior three months;
  5. History of allergy or intolerable side-effects to olanzapine in the past;
  6. History of significant head trauma, defined as head trauma resulting in loss of consciousness for more than five minutes and/or neurological or cognitive sequelae;
  7. Evidence of any clinically relevant disease (e.g., renal or hepatic impairment, significant coronary artery disease, cerebrovascular disease, or cancer) or any clinical finding that in the opinion of the investigator could potentially be negatively affected by study participation or that could potentially affect study participation is criterion for exclusion from the study;
  8. Use of fluvoxamine, nifedipine, or warfarin for 30 days prior to Baseline Visit.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00512070

Contacts
Contact: Amanda E Wood, PhD (253) 583-1652 amanda.wood@va.gov

Locations
United States, Washington
VA Puget Sound Health Care System Recruiting
Tacoma and Seattle, Washington, United States, 98493
Sponsors and Collaborators
Seattle Institute for Biomedical and Clinical Research
Eli Lilly and Company
Investigators
Principal Investigator: Nael Kilzieh, M.D. VA Puget Sound Health Care System, Seattle and Tacoma, WA; University of Washington, Dept. of Psychiatry and Behavioral Sciences
  More Information

Publications:

Responsible Party: Nael Kilzieh, M.D., Principal Investigator, VA Puget Sound Health Care System
ClinicalTrials.gov Identifier: NCT00512070    
History of Changes
Other Study ID Numbers: F1D-MC-X302
Study First Received: August 3, 2007
Last Updated: April 22, 2011
Health Authority: United States: Institutional Review Board

Keywords provided by Seattle Institute for Biomedical and Clinical Research:

schizophrenia
schizoaffective disorder
bipolar disorder
olanzapine
melatonin
obesity
metabolic syndrome

Additional relevant MeSH terms:

Congenital Abnormalities
Bipolar Disorder
Obesity
Psychotic Disorders
Schizophrenia
Metabolic Syndrome X
Affective Disorders, Psychotic
Mood Disorders
Mental Disorders
Overnutrition
Nutrition Disorders
Overweight
Body Weight
Signs and Symptoms
Schizophrenia and Disorders with Psychotic Features
Insulin Resistance
Hyperinsulinism
Glucose Metabolism Disorders
Metabolic Diseases
Melatonin
Olanzapine
Central Nervous System Depressants
Physiological Effects of Drugs
Pharmacologic Actions
Central Nervous System Agents
Therapeutic Uses
Antioxidants
Molecular Mechanisms of Pharmacological Action
Protective Agents
Antipsychotic Agents

ClinicalTrials.gov processed this record on November 28, 2011

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