This application provides the candidate with the expertise and skills needed to study metabolic disorders, as well as psychopathology and cognitive function in patients with schizophrenia. The candidate proposes a career development plan that consists of coursework, directed learning and mentored research projects in the early years of the award, and emphasizes follow-up studies and preparation of manuscripts and grants in the later years. The training and the proposed projects will serve as a foundation for the candidate's independent clinical research in the future. The candidate proposes a series of studies to be conducted over the 5-year award period. These studies will focus on two major themes: 1) exploring the mechanisms of antipsychotic-induced metabolic disturbances in schizophrenia patients as well as in healthy subjects;2) interventional studies to address metabolic disturbances, psychopathology, and cognitive impairment in schizophrenia patients. Ultimately these proposed studies will lead to the development of innovative interventional strategies to treat medical comorbidity and possibly to improve psychiatric symptoms and cognitive deficits in patients with this devastating mental illness. As a representative study, the candidate proposes a 12-week, randomized, double-blind, placebo-controlled trial of telmisartan 80 mg/day, as an adjunctive therapy in 70 clozapine or olanzapine treated schizophrenia patients. The primary aims are to examine the efficacy of telmisartan in: 1) improving insulin resistance and glucose metabolism based on changes in insulin sensitivity index (SI), glucose effectiveness (SG) and the acute insulin response to glucose (AIRG) using the frequently sampled intravenous glucose tolerance test (FSIVGTT) and Bergman's minimal model analysis;2) reducing fasting plasma triglycerides and LDL;3) improving positive symptoms, negative symptoms and cognitive impairment. Obesity, diabetes and cardiovascular disease are much more common in schizophrenia patients compared with the general population. The high prevalence of these serious medical problems apparently contributes to the high mortality rate of this patient population, which is approximately twice that of the general population. The research area proposed by the candidate addresses a critical yet under studied public health issue.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH082098-03
Application #
7846219
Study Section
Interventions Committee for Disorders Related to Schizophrenia, Late Life, or Personality (ITSP)
Program Officer
Chavez, Mark
Project Start
2008-06-12
Project End
2013-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
3
Fiscal Year
2010
Total Cost
$184,731
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Luo, Yanli; Liu, Fang; Natarajan, Radhika et al. (2017) Salsalate as an adjunctive treatment for psychopathology and cognition in patients with schizophrenia: a pilot study. Int Clin Psychopharmacol :
Fan, X; Song, X; Zhao, M et al. (2017) The effect of adjunctive telmisartan treatment on psychopathology and cognition in patients with schizophrenia. Acta Psychiatr Scand 136:465-472
Vincenzi, Brenda; Stock, Shannon; Borba, Christina P C et al. (2014) A randomized placebo-controlled pilot study of pravastatin as an adjunctive therapy in schizophrenia patients: effect on inflammation, psychopathology, cognition and lipid metabolism. Schizophr Res 159:395-403
Sheng, Jianhua; Li, Chunbo; Wang, Jijun et al. (2014) Phenotypic characteristics in metabolically healthy but obese patients with schizophrenia. Psychiatry Res 220:71-5
Li, Jie; Li, Xue; Liu, Emily et al. (2013) No effect of adjunctive, repeated dose intranasal insulin treatment on body metabolism in patients with schizophrenia. Schizophr Res 146:40-5
Fan, Xiaoduo; Liu, Emily; Freudenreich, Oliver et al. (2013) No effect of adjunctive, repeated-dose intranasal insulin treatment on psychopathology and cognition in patients with schizophrenia. J Clin Psychopharmacol 33:226-30
Henderson, David C; Fan, Xiaoduo; Copeland, Paul M et al. (2009) Aripiprazole added to overweight and obese olanzapine-treated schizophrenia patients. J Clin Psychopharmacol 29:165-9