Allopurinol Maintenance Study for Bipolar Disorder

This study has been completed.
Sponsor:
Collaborator:
West Coast College of Biological Psychiatry
Information provided by:
Cedars-Sinai Medical Center
ClinicalTrials.gov Identifier:
NCT00732251
First received: August 7, 2008
Last updated: March 26, 2012
Last verified: March 2012
  Purpose

The purpose of this study is to investigate the efficacy of allopurinol as an augmentation agent for the prevention of mania in bipolar disorder patients with currently stable mood.


Condition Intervention Phase
Bipolar Disorder
Mania
Mixed Mania
Drug: Allopurinol
Phase 4

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: An Open Label, Naturalistic Study With Allopurinol Augmentation for Prevention of Mania in Bipolar Disorder

Resource links provided by NLM:


Further study details as provided by Cedars-Sinai Medical Center:

Primary Outcome Measures:
  • Young Mania Rating Scale (YMRS) [ Time Frame: 2 Years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Hamilton Depression Scale (HAM-D) [ Time Frame: 2 Years ] [ Designated as safety issue: No ]

Enrollment: 15
Study Start Date: August 2008
Study Completion Date: January 2012
Primary Completion Date: January 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Allopurinol Drug: Allopurinol
Allopurinol: 300-600 mg/day over a 4 week period

Detailed Description:

The purpose of this study is to investigate the efficacy of allopurinol as an augmentation agent for the prevention of mania in bipolar disorder patients with currently stable mood. Bipolar disorder is a mental disorder with severe mood swings (mania and depression). Despite the development of medications for mania, they may have significant side effects, high costs and the need for serum level monitoring. These factors adversely affect medication compliance in bipolar patients. One recent study indicated the efficacy of allopurinol in the treatment of bipolar mania. Our hypothesis is that the addition of allopurinol to standard medications for bipolar disorder will decrease the recurrences of manic episodes compared to standard medications.

This study will recruit bipolar disorder patients currently mood stable on a therapeutic dose of an anti-manic medication. Stable mood will be defined as a Young Mania Rating Scale score ≤10 and Hamilton Depression Rating Scale ≤10. Subjects must have a diagnosis of bipolar disorder confirmed by the Mini International Neuropsychiatric Interview (MINI). YMRS and MINI are common research questionnaires used in bipolar disorder studies. Potential subjects will be identified and approached during an outpatient clinical visit by a member of the research team and identified by their treating physicians and referred to the researchers.

This study involves adding allopurinol to subjects' current bipolar medications. This study will be a open label, naturalistic study. The subject will be examined monthly for manic symptoms for 2 years. Semi-structured interviews and study questionnaires will be administered to subjects at each visit. Monthly Follow-up Study Visits (once per month for 2 years - Months 1-5, 7-11, 13-17, 19-23) may be conducted either in-person or over the phone. All of the questionnaires will be administered by a clinician if the visit is completed over the phone. However, the 6-month interval visits (Months 6, 12, 18, and 24) must be done at the research center.

The primary outcome measure will be the number of manic episodes in the 2 year study period. We will also measure the changes in medication doses that subjects in each group need to maintain mood stability.

  Eligibility

Ages Eligible for Study:   18 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Subjects must be between ages 18 and 70.
  2. Subjects must meet DSM-IV criteria for bipolar disorder confirmed by the Mini International Neuropsychiatric Interview (MINI).
  3. Subjects must be taking at least one medication for mania at a therapeutic dose for at least 2 weeks.
  4. Subjects must have been diagnosed with bipolar disorder, type 1, for at least 2 years prior to baseline.
  5. Subjects must have adequate response to medications as evidenced by Young Mania Rating Scale (YMRS) score less than or equal to 10 at screening and at baseline.
  6. Subjects must have adequate response to medications as evidenced by Hamilton Depression Rating Scale (HAM-D) score less than or equal to 10 at screening and at baseline.
  7. Subjects must have had at least 1 manic episode in the 2 year period prior to entering the study.
  8. Female subjects must be either postmenopausal for at least 1 year, surgically sterile, abstinent or practicing an effective method of birth control if sexually active. Acceptable methods of birth control during this study are regular use of contraceptive pills, intra-uterine devices, barrier methods or abstinence. Female subjects must also have a negative urine pregnancy test at screening, baseline and other time points throughout the study.
  9. Subjects must be able and willing to comply with self-administration of medication or have consistent help/support available.
  10. Subjects must have signed an informed consent document indicating that they understand the purpose of and procedures required for the study and are willing to participate in the study.
  11. Subjects must be able and willing to meet or perform study requirements (e.g. answer self-administered questionnaires).
  12. Subjects must be willing to allow study staff to contact subject's regular psychiatrist while the subject is in the study.

Exclusion Criteria:

  1. Subjects who are unable to provide informed consent.
  2. Subjects with a serious, unstable medical illness (such as cardiovascular, respiratory, neurologic, hematologic, renal, hepatic, endocrine, immunologic, or other systemic illness), a history of cerebrovascular disease, uncontrolled diabetes mellitus or AIDS. Subjects with chronic illness must be stable and otherwise physically healthy on the basis of a physical examination, medical history, electrocardiogram and the results of blood biochemistry, hematology tests and a urinalysis.
  3. Subjects who develop a medical condition during participation which can affect mood stability (i.e. seizure disorder, brain tumors, brain trauma, stroke, multiple sclerosis, etc.)
  4. Subjects who develop substance abuse or dependence during participation in the study.
  5. Subjects taking azathioprine, mercaptopurine, apalcillin, and/or amoxicillin.
  6. Subjects who have been intoxicated with alcohol or drugs within the last 72hrs.
  7. Subjects with a history of severe pre-existing gastrointestinal narrowing or inability to swallow oral study medication whole with the aid of water.
  8. Female subjects who are pregnant or nursing.
  9. Subjects who have previously participated in this study.
  10. Subjects with an anticipated life expectancy of 6 months or less.
  11. Subjects who have received an experimental drug or used an experimental medical device within 1 month of screening.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00732251

Locations
United States, California
Cedars-Sinai Medical Center
Los Angeles, California, United States, 90048
Sponsors and Collaborators
Cedars-Sinai Medical Center
West Coast College of Biological Psychiatry
Investigators
Principal Investigator: Alexander Fan, M.D. Cedars-Sinai Medical Center
  More Information

Additional Information:
No publications provided

Responsible Party: Dr. Alexander Fan, M.D., Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neuroscience
ClinicalTrials.gov Identifier: NCT00732251     History of Changes
Other Study ID Numbers: IRB13414
Study First Received: August 7, 2008
Last Updated: March 26, 2012
Health Authority: United States: Federal Government

Keywords provided by Cedars-Sinai Medical Center:
Bipolar Disorder
Stable Bipolar Disorder
Mania
Mixed mania
Allopurinol

Additional relevant MeSH terms:
Bipolar Disorder
Affective Disorders, Psychotic
Mood Disorders
Mental Disorders
Allopurinol
Antimetabolites
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Enzyme Inhibitors
Gout Suppressants
Antirheumatic Agents
Therapeutic Uses
Free Radical Scavengers
Antioxidants
Protective Agents
Physiological Effects of Drugs

ClinicalTrials.gov processed this record on August 21, 2014