Clinical trial

The Effects of Kynurenine Aminotransferase Inhibition in People With Schizophrenia

Name
HP-00086009
Description
Kynurenic acid (KYNA) is a naturally occurring chemical in the brain. Studies with rodents indicate that levels of KYNA can impact levels of the neurotransmitters glutamate and dopamine. One way to reliably increase KYNA levels is by ingesting the amino acid tryptophan. Tryptophan is a normal part of the human diet. Tryptophan gets metabolized/changed to other chemicals in the body- including KYNA. By giving people 6 grams of tryptophan, the investigators will be able to increase the KYNA level in a controlled way. The investigators will then be able to study the effects of KYNA on neurotransmitters by using cognitive tests and magnetic resonance imaging techniques (measuring brain activity and brain chemistry using the MRI magnet). The overall goal of the study is to examine how the medication N-acetylcysteine (NAC), when added to tryptophan, affects various cognitive functions, such as verbal and visual memory. The investigators will also use magnetic resonance imaging (MRI) to examine how NAC affects brain activity and chemicals.
Trial arms
Trial start
2020-01-20
Estimated PCD
2024-06-30
Trial end
2024-06-30
Status
Recruiting
Phase
Early phase I
Treatment
N-acetylcysteine (NAC)
Flavored effervescent formulation
Arms:
N-acetylcysteine & Tryptophan
Other names:
Cetylev
Placebo
Flavored effervescent formulation designed to mimic NAC
Arms:
Placebo & Tryptophan
Tryptophan
Oral slurry form
Arms:
N-acetylcysteine & Tryptophan, Placebo & Tryptophan
Size
75
Primary endpoint
Serum kynurenine levels
Change from baseline after 4 hours, 5.5 hours, and 7 hours on each Challenge Day.
Kynurenic acid levels
Change from baseline after 4 hours, 5.5 hours, and 7 hours on each Challenge Day.
Whole brain gray matter and frontal gray matter cerebral blood flow (CBF)
Change from baseline after 3 hours on each Challenge Day.
Medial prefrontal cortex glutamate levels using magnetic resonance spectroscopy (MRS)
Change from baseline after 3 hours on each Challenge Day.
Medial prefrontal cortex glutathione metabolite levels using magnetic resonance spectroscopy (MRS)
Change from baseline after 3 hours on each Challenge Day.
Eligibility criteria
Inclusion Criteria: * Males and females * Age: 18 to 55 years * DSM-5 Criteria for schizophrenia, schizoaffective disorder or schizophreniform disorder (documented by SCID) * Prescription of antipsychotic medication for at least 60 days and constant dose for 30 days prior to study entry (either first or second generation antipsychotics permitted) * Female participants must agree to use a medically accepted means of contraception Exclusion Criteria: * DSM-5 alcohol or substance misuse disorder in the last 3 months (documented by SCID) * History of an organic brain disorder; mental retardation; or a medical condition, whose pathology or treatment could alter cognition * Active disorders that have been reported to affect tryptophan metabolism or interfere with absorption will be excluded (Acute Intermittent Porphyria, Celiac Disease, Crohn's Disease, Irritable Bowel Syndrome; Brune and Pflughaupt 1975; Torres et al 2007). * Excessive self-reported daily caffeine intake, defined as intake exceeding 1000mg or the equivalent of 8 cups of coffee * Pregnancy or lactation * No metal in body that will interfere with MR imaging * Monoamine oxidase inhibitors, migraine headache medications (triptans) and dextromethorphan * Forensic or legal issues
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE1', 'PHASE2'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'CROSSOVER', 'interventionModelDescription': 'This will be a double-blind, placebo-controlled, randomized cross-over challenge study. Participant randomization will use a permuted block randomization system (block sizes 2 or 4), in which treatment assignment order is random within each block, with an equal number of participants assigned to each treatment, to generate a list of treatment assignments. Thus, it will be difficult to ascertain the next treatment assignment, even if a participant becomes unblinded, while any imbalance in the number of participants between the treatment groups will be kept within tight limits.', 'primaryPurpose': 'OTHER', 'maskingInfo': {'masking': 'QUADRUPLE', 'maskingDescription': 'All raters, investigators and other staff will be blind to treatment assignment except for the research pharmacist. The research pharmacist does not participate in assessing any of the primary symptom or side effect dependent variables and conveys no information about treatment assignment to participants or staff except in a medical emergency.', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}}, 'enrollmentInfo': {'count': 75, 'type': 'ESTIMATED'}}
Updated at
2023-12-15

1 organization

3 products

3 indications

Indication
Schizophrenia
Product
Placebo
Product
Tryptophan