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Schizophrenia affects approximately 1% of the population worldwide, and in about 80% of cases, it is a lifelong, disabling illness. It is a multi-dimensional disease that is associated with symptoms that have been characterized as positive, negative, and cognitive. CDS is a core feature of schizophrenia, and most individuals with schizophrenia exhibit cognitive impairment. Attention disorders, slow information processing, working memory disorders, and lack of flexibility for adaptive strategies are symptoms of cognitive impairment that have a devastating impact on the function, employment, and social status of patients with schizophrenia.
Older typical neuroleptic medications (e.g., haloperidol, fluphenazine) do not improve cognition. In fact, haloperidol has been shown to induce cognitive impairment in schizophrenic patients.
Novel atypical antipsychotics, such as risperidone, clozapine, and olanzapine, seem to produce gains in cognition. This improvement may reflect a diminution of extrapyramidal side effects of the typical high potency neuroleptics. Alternatively, it might reflect more effective symptom reduction by the novel antipsychotics, or direct cognitive enhancement through the effects of the newer agents on a variety of neurotransmitters, their receptors, and gene expression. Even when the newer antipsychotic medications improve cognition, they do not normalize it.
Presently, there are no approved therapies for CDS. However, in schizophrenic patients, nicotine improves multiple cognitive domains, including working memory and attention. Furthermore, based on a strong body of evidence ranging from genetic mapping to clinical trials, the alpha7 NNR subtype has emerged as a primary therapeutic target relevant to CDS and other core symptoms of schizophrenia
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TC-5619 | Experimental | TC-5619 capsules will be administered once a day in a forced titration scheme at 1 mg for 4 weeks, 5 mg for 4 weeks and 25 mg for 4 weeks (12 weeks total). |
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| Placebo | Placebo Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TC-5619 | Drug | TC-5619-238 will be provided as hard gelatin capsules in strengths of 1mg, 5mg, and 25mg. |
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| Measure | Description | Time Frame |
|---|---|---|
| To assess the efficacy of TC-5619 as augmentation therapy to quetiapine or risperidone, to improve cognition in stable outpatients with Cognitive Dysfunction in Schizophrenia (CDS), using the GML test of the CogState Schizophrenia Test Battery (CSTB). | Day 1 - Week 4; Week 4 - Week 8; and finally Week 8 - Week 12. There will be a 2-week follow-up period following the end of the treatment period. |
| Measure | Description | Time Frame |
|---|---|---|
| Assess the efficacy, safety and tolerability of TC-5619 administered adjunctively with quetiapine or risperidone, evaluate the pharmacokinetics of TC-5619 and plasma levels of quetiapine and risperidone/9-OH-risperidone. | Day 1 - Week 4; Week 4 - Week 8; and finally Week 8 - Week 12. There will be a 2-week follow-up period following the end of the treatment period. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jeffrey Lieberman, MD | New York State Psychiatrii Institute, Columbia University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Synergy Clinical Research Center | National City | California | 91950-7628 | United States | ||
| Collaborative Neuroscience Network, Inc LA County |
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| Placebo | Drug | Placebo will be provided with exactly the same shape, size and appearance. |
|
| Torrance |
| California |
| 90502 |
| United States |
| Altanta Center for Medical Research | Atlanta | Georgia | 30308 | United States |
| Clinical Research Institute | Wichita | Kansas | 67211 | United States |
| Neurobehavioral Reseach, Inc. | Cedarhurst | New York | 11516 | United States |
| New York State Pshychiatric Institute, Columbia University | New York | New York | 10032 | United States |
| Community Clinical Research, Inc. | Austin | Texas | 78754 | United States |
| Sravani Polyclinic and Mental Health Care Centre | Guntur | Andhra Pradesh | 522001 | India |
| Asha Hospital | Hyderabaad | Andhra Pradesh | 500034 | India |
| Dept. of Psychiatry, Owaisi Hospital & Research Centre | Hyderabaad | Andhra Pradesh | 500058 | India |
| Brain Mind Behaviour Neuroscience Research Institute | Visakhapatnam | Andhra Pradesh | 530002 | India |
| Government Hospital for Mental Care | Visakhapatnam | Andhra Pradesh | 530017 | India |
| Adhit Khan Neuropsychiatric Centre | Mangalore | Karnataka | 575002 | India |
| Dept. of Psychiatry, JSS University | Mysore | Karnataka | 57004 | India |
| Mahendru Psychiatric Centre | Kanpur | Uttar Pradesh | 208005 | India |
| Dept. of Psychiatry, CSM University | Lucknow | Uttar Pradesh | 226003 | India |
| ID | Term |
|---|---|
| D060825 | Cognitive Dysfunction |
| D012559 | Schizophrenia |
| ID | Term |
|---|---|
| D003072 | Cognition Disorders |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
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| ID | Term |
|---|---|
| C543641 | N-(2-(pyridin-3-ylmethyl)-1-azabicyclo(2.2.2)oct-3-yl)-1-benzofuran-2-carboxamide |
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