Schizophrenia
Conditions
Brief summary
Schizophrenia is a heterogeneous mental disorder that affects one percent of the world's population. Current antipsychotics are only partially effective, and their use is often associated with serious side effects. Cannabidiol is a natural counterpart of the psychoactive component of marijuana, delta-9-tetrahydrocannabinol. While cannabidiol has no psychotomimetic or addictive properties, it indirectly affects endogenous cannabinoid signalling by impairing the degradation of the endocannabinoid anandamide. In a controlled clinical trial of cannabidiol versus amisulpride (an established antipsychotic) in acute paranoid schizophrenics the investigators showed a significant clinical improvement in all symptoms of schizophrenia compared to baseline with either treatment. But cannabidiol displayed a significantly superior side-effect profile. This study is to evaluate the efficacy and safety of this novel treatment option in comparison to placebo and olanzapine, an established second generation antipsychotic in the treatment of acute schizophrenia and schizophrenia maintenance therapy, in a four-week clinical trial.
Interventions
DRUGCannabidiol
Cannabidiol capsules
DRUGOlanzapine
Olanzapine capsules
Placebo cannabidiol capsules
Placebo olanzapine capsules
Sponsors
Martin-Luther-Universität Halle-Wittenberg
Heidelberg University
Technical University of Munich
Ludwig-Maximilians - University of Munich
Glostrup University Hospital, Copenhagen
Central Institute of Mental Health, Mannheim
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Informed consent given by the subject * DSM-IV-TR diagnosis of schizophrenic psychosis (295.10, 295.20, 295.30, 295.90 (American Psychiatric Association) * Patients must be within the first three years of illness, i.e. first diagnosis of schizophrenia is no older than three years. * Age 18 to 65 years, male or female * Minimal initial PANSS score of 75 at baseline * Female patients of childbearing potential need to utilize a proper method of contraception. * Body Mass Index between 18 and 40
Exclusion criteria
* Lack of accountability (assessed by an independent psychiatrist) * History of treatment-resistant schizophrenia, defined as no response to at least two antipsychotics given for a minimum of 6 weeks each in an adequate dosage * Positive urine drug-screening for illicit drugs at screening (except cannabinoids and benzodiazepines) * Serious suicidal risk at screening visit (Subject to investigator's and independent psychiatrist's judgement: Poses a serious suicidal or homicidal risk at screening visit or has made a serious suicide attempt within the last 12 months prior to screening visit, or has exhibited homicidal behaviour at anytime during her/his lifetime) * Known intolerance or allergy to olanzapine or cannabidiol * Other relevant interferences of axis 1 (e.g. serious depression) according to diagnostic evaluation (MINI) including residual forms of schizophrenia * Pregnancy, as determined through a β-HCG pregnancy test, or lactation
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in the Positive and Negative Syndrome Scale (PANSS) total score | within 4 weeks |
Secondary
| Measure | Time frame |
|---|---|
| Changes in the Clinical Global Impression score | within 4 weeks |
| Changes in the Global Assessment of Functioning Scale | within 4 weeks |
| Changes in the Personal and Social Performance Scale | within 4 weeks |
| Changes in the Calgary Depression Scale for Schizophrenia | within 4 weeks |
| Changes in the Hamilton Anxiety Scale | within 4 weeks |
| Changes in the PANSS subscores and clusters | within 4 weeks |
| Response to antipsychotic medication | within 4 weeks |
| Plasma levels of endogenous cannabinoids | within 4 weeks |
| Changes in physiological parameter | within 4 weeks |
| Changes in the UKU Side Effect Rating Scale | within 4 weeks |
| Columbia Suicidality Severity Rating Scale | within 4 weeks |
| Changes in cognitive skills | within 4 weeks |
Countries
Denmark, Germany
Outcome results
None listed