Project Details
Abstract
Schizoaffective disorder (SAD) is a chronic, severe and disabling mental illness characterized by the
concurrent presentation of symptoms of schizophrenia and affective disorders. Specific drug treatment for
SAD remains a largely unexplored topic although combinations of antipsychotics and mood stabilizers are
commonly used in clinical practice. Very recently, the Taiwan Bipolar Consortium discovered glutamate
decarboxylase-like 1 (GADL1) variants strongly associated with the response to lithium prophylaxis
treatment in type I bipolar disorder with a sensitivity of 93% for predicting a response to lithium. To our
knowledge, this is the first study that uses genetic markers with sufficient sensitivity for predicting
treatment response in mental disorder. This finding would serve as a milestone in personalized
pharmacotherapy in psychiatry. The investigators of this study are from the key members of the Taiwan
Bipolar Consortium. We have the best chance to extrapolate these findings from type I bipolar disorder to
other affective disorders. This proposed study aims to clarify the role of mood stabilizers in the
pharmacotherapy for schizoaffective disorder, bipolar type (SAD-BP), with a specific aim to test the
association of lithium response and GADL1 variants. A total of 500 patients with SAD will be recruited for
retrospective and/or two-year follow-up study of effects and adverse effects of mood stabilizers. Those who
are experiencing an acute exacerbation of illness will be randomized into 8-week acute management with
antipsychotic monotherapy or mood stabilizer adjunctive therapy. After management of acute exacerbation,
the subjects will enter the maintenance therapy with the regimens they have good response to during acute
management. The measure for efficacy of acute management is change in Positive and Negative Syndrome
Scale total score from baseline to endpoint. Treatment response for maintenance therapy will be assessed
using the Alda Scale. Statistical analyses include effects and adverse effects of mood stabilizers collected
retrospectively and prospectively. We will also compare overall allele and genotype frequencies of
rs17026688 between lithium responders and non-responders.
Project IDs
Project ID:PC10307-0108
External Project ID:MOST103-2314-B182-011-MY3
External Project ID:MOST103-2314-B182-011-MY3
Status | Finished |
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Effective start/end date | 01/08/14 → 31/07/15 |
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