ITI-1284 for Psychosis in Alzheimer's Disease

Recruiting at 51 trial locations

Overseen By ITI Clinical Trials

Age: 18+

Sex: Any

Trial Phase: Phase 2

Sponsor: Intra-Cellular Therapies, Inc.

Must not be taking: Psychotropics, CNS drugs

Disqualifiers: Schizophrenia, Bipolar, Suicide risk, others

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

370 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether the medication ITI-1284 (deuterated lumateperone) can treat psychosis in people with Alzheimer's disease. Researchers aim to determine the safety and effectiveness of this treatment compared to a placebo (a non-active substance). Participants will receive either ITI-1284 or a placebo to compare outcomes. This trial may suit individuals with Alzheimer's-related psychosis who are not in hospice care or hospitalized for other conditions. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group, allowing participants to contribute to early-stage findings.

Will I have to stop taking my current medications?

You may need to stop taking certain medications, especially those with psychotropic properties (affecting the mind) or those that impact the central nervous system. It's best to discuss your current medications with the study team to see if any changes are needed.

Is there any evidence suggesting that ITI-1284 is likely to be safe for humans?

Research has shown that ITI-1284 is likely safe. Studies on a similar drug, lumateperone, used for treating schizophrenia, found it was well-tolerated and did not cause major side effects like movement problems. This suggests ITI-1284 might also be safe for people with Alzheimer's disease, but further research is needed. The trial under consideration is in an early stage, focusing on assessing safety in humans. This stage aims to identify any potential issues before progressing to larger studies. ^{1 2 3 4}

Why do researchers think this study treatment might be promising for Alzheimer's disease?

Most treatments for psychosis in Alzheimer's disease, like antipsychotics, work by blocking dopamine receptors to manage symptoms. But ITI-1284 is different because it is derived from a compound called lumateperone, which targets a unique combination of serotonin, dopamine, and glutamate receptors. This multi-receptor approach has the potential to improve symptoms with fewer side effects, making it a promising option for those with Alzheimer's-related psychosis. Researchers are particularly excited about ITI-1284 because it could offer a more balanced and safer treatment alternative, addressing the complex chemical imbalances in the brain associated with Alzheimer's disease.

What evidence suggests that ITI-1284 might be an effective treatment for psychosis in Alzheimer's disease?

Research has shown that ITI-1284, a drug similar to lumateperone, may help treat psychosis in Alzheimer's disease. Lumateperone has been used safely in people with schizophrenia without causing major side effects like movement problems. This indicates that ITI-1284 could also be safe and beneficial for Alzheimer's patients experiencing symptoms such as delusions or hallucinations. In this trial, participants will receive either ITI-1284 or a placebo to assess its effectiveness and safety. ITI-1284 is being developed specifically to address behavioral issues in dementia. Although more research is needed, early results are promising for its use in treating psychosis related to Alzheimer's. ^{1 2 3 4 5}

Are You a Good Fit for This Trial?

This trial is for people with Alzheimer's who are experiencing psychosis. Participants should be diagnosed with Alzheimer's Disease and currently have symptoms of psychosis. The study excludes individuals who don't meet the specific diagnostic criteria, those on certain medications, or anyone whose condition might interfere with the study.

Inclusion Criteria

Has a designated caregiver

My tests show signs of Alzheimer's disease.

Meets criteria for psychosis in accordance with the International Psychogeriatric Association (IPA) provisional consensus definition at Screening and Baseline

Exclusion Criteria

Risk for suicidal behavior during the study or considered an imminent danger to themselves or others

I have been diagnosed with schizophrenia, schizoaffective disorder, or another psychotic disorder not related to Alzheimer's, or bipolar disorder.

I am not bedridden and do not have a severe unstable health condition.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

up to 4 weeks

Treatment

Participants receive either ITI-1284 or placebo in a double-blind manner

6 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

30 days

What Are the Treatments Tested in This Trial?

Interventions

• ITI-1284

Trial Overview

The trial is testing ITI-1284 to see if it helps treat psychosis in Alzheimer's patients compared to a placebo (a substance with no active drug). It’s a controlled test where patients are randomly chosen to receive either ITI-1284 or placebo without knowing which one they're getting.

How Is the Trial Designed?

Group I: ITI-1284 Experimental Treatment 1 Intervention

Group II: Placebo Placebo Group 1 Intervention

Who Is Running the Clinical Trial?

Intra-Cellular Therapies, Inc.

Lead Sponsor

Trials

42

Recruited

10,700+

Published Research Related to This Trial

Lumateperone tosylate is a first-in-class investigational drug that works through multiple neurotransmitter systems, including serotonergic, dopaminergic, and glutamatergic pathways, which may lead to rapid antidepressant effects.

In clinical trials, lumateperone demonstrated a safety profile similar to placebo, with significant improvements in both depressive and psychotic symptoms in patients with schizophrenia, indicating its potential for treating various mood disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lumateperone: a new treatment approach for neuropsychiatric disorders. Kumar, B., Kuhad, A., Kuhad, A.[2019]

In a study analyzing participants from the Alzheimer's Disease Neuroimaging Initiative 2, it was found that individuals with misidentification psychosis experienced a significantly faster cognitive decline in Alzheimer's disease, with a rate of increase in cognitive scores that was doubled compared to nonpsychotic patients.

The findings suggest that misidentification may represent a distinct subtype of Alzheimer's disease, indicating that different types of psychosis could be linked to varying rates of disease progression.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Misidentification Subtype of Alzheimer's Disease Psychosis Predicts a Faster Cognitive Decline. D'Antonio, F., Reeves, S., Sheng, Y., et al.[2021]

In a study of 301 outpatients with stable schizophrenia, lumateperone was found to be well tolerated, with only 45.5% experiencing treatment-emergent adverse events, most of which were mild or moderate, and a very low incidence of extrapyramidal symptoms (1.0%).

Patients switching to lumateperone showed significant improvements in metabolic parameters, such as reduced cholesterol and body weight, while maintaining stable schizophrenia symptoms, indicating its safety and efficacy compared to previous antipsychotic treatments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Safety and tolerability of lumateperone 42 mg: An open-label antipsychotic switch study in outpatients with stable schizophrenia. Correll, CU., Vanover, KE., Davis, RE., et al.[2021]

In a 16-week study involving 53 patients with moderate to moderately severe Alzheimer's disease, memantine significantly improved behavioral disturbances, as indicated by a 4.6-point reduction in the Neuropsychiatric Inventory (NPI) score (p<0.01).

The study also found notable reductions in caregiver distress and specific symptoms such as depression, aberrant motor behavior, and agitation, suggesting memantine's efficacy in managing various neuropsychiatric symptoms associated with Alzheimer's.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Memantine for treatment of behavioural disturbances and psychotic symptoms in moderate to moderately severe Alzheimer dementia: a naturalistic study in outpatient services in Austria]. Schmidt, R., Baumhackl, U., Berek, K., et al.[2013]

In a study involving 10 patients with schizophrenia, lumateperone (ITI-007) demonstrated a mean dopamine D2 receptor occupancy of 39% after a 60 mg dose, which is lower than most traditional antipsychotics, potentially leading to fewer side effects.

Lumateperone was well-tolerated with no significant adverse effects, such as motor disturbances or increased prolactin levels, suggesting it may offer a safer treatment alternative for schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dopamine D2 receptor occupancy of lumateperone (ITI-007): a Positron Emission Tomography Study in patients with schizophrenia. Vanover, KE., Davis, RE., Zhou, Y., et al.[2020]

Lumateperone (LUM) has been shown to significantly reduce the severity of schizophrenia symptoms compared to placebo, based on data from four clinical studies involving randomized controlled trials and an open-label trial.

LUM has a favorable safety and tolerability profile, exhibiting placebo-level rates of weight gain, metabolic changes, and extrapyramidal side effects, making it a strong candidate for first-line treatment in adults with schizophrenia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lumateperone for the Treatment of Adults With Schizophrenia: a Systematic Review. Jawad, MY., Alnefeesi, Y., Ceban, F., et al.[2022]

Lumateperone (ITI-007) has a unique mechanism of action that targets multiple neurotransmitter systems, including serotonin, dopamine, and glutamate, making it a promising treatment for schizophrenia and potentially other psychiatric conditions.

It has shown a favorable safety profile, with no significant side effects like extrapyramidal symptoms or hyperprolactinemia, suggesting it could be a safer alternative to traditional antipsychotics.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence on the New Drug Lumateperone (ITI-007) for Psychiatric and Neurological Disorders. Mazza, M., Marano, G., Traversi, G., et al.[2021]

Lumateperone (Caplyta®) is a first-in-class medication that modulates serotonin, dopamine, and glutamate, making it a unique treatment option for schizophrenia and potentially other neuropsychiatric disorders.

Approved in December 2019 for schizophrenia in adults, lumateperone is also being studied for various conditions, including bipolar depression and Alzheimer's-related behavioral disorders, highlighting its broad therapeutic potential.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lumateperone: First Approval. Blair, HA.[2021]

Lumateperone is a first-in-class investigational drug for schizophrenia that works by targeting multiple neurotransmitter systems, including serotonergic, glutamatergic, and dopaminergic pathways, which may help alleviate a wide range of symptoms associated with the disorder.

Clinical trials suggest that lumateperone has unique pharmacological properties that could significantly improve schizophrenia symptoms, and future studies are expected to provide more insights into its long-term efficacy and safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evaluation of lumateperone tosylate for the treatment of schizophrenia. Vyas, P., Hwang, BJ., Brašić, JR.[2020]

Vitamin D usage was more common among Alzheimer's disease patients without psychosis symptoms, and it was linked to a delay in the onset of psychosis, suggesting a potential preventive role.

The study identified that vitamin D affects genes related to calcium signaling, which may help in developing new treatments for psychosis in Alzheimer's patients, and genetic variations in these genes could help identify patients who might benefit from vitamin D therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Vitamin D Use on Outcomes of Psychotic Symptoms in Alzheimer Disease Patients. Wang, L., Ying, J., Fan, P., et al.[2020]

In a study involving 313 individuals with moderate Alzheimer's disease, treatment with divalproex sodium (valproate) did not delay or prevent the emergence of agitation or psychosis compared to a placebo, indicating it may not be an effective intervention for these symptoms.

The valproate group experienced significant side effects, including increased somnolence, gait disturbances, and greater brain volume loss, suggesting that the risks of using valproate may outweigh any potential benefits in this patient population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Chronic divalproex sodium to attenuate agitation and clinical progression of Alzheimer disease. Tariot, PN., Schneider, LS., Cummings, J., et al.[2022]

An international expert panel emphasized a non-pharmacologic first-line approach for managing behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease, recommending caregiver training and environmental adaptations before considering medications.

For pharmacologic treatment, citalopram and analgesia were preferred for agitation, while risperidone was prioritized for psychosis, highlighting the need for careful assessment of underlying causes before medication use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Management of behavioral and psychological symptoms in people with Alzheimer's disease: an international Delphi consensus. Kales, HC., Lyketsos, CG., Miller, EM., et al.[2022]

In a 6-week study involving 71 Alzheimer's patients, standard-dose haloperidol (2-3 mg/day) was found to be significantly more effective than both low-dose haloperidol (0.50-0.75 mg/day) and placebo in reducing psychosis and agitation, with response rates of 55%-60% for the standard dose.

While standard-dose haloperidol showed efficacy, it also led to a higher incidence of extrapyramidal side effects in some patients, suggesting that a cautious approach with a starting dose of 1 mg/day and gradual increases is advisable to minimize risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomized, placebo-controlled dose-comparison trial of haloperidol for psychosis and disruptive behaviors in Alzheimer's disease. Devanand, DP., Marder, K., Michaels, KS., et al.[2022]

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Many people with Alzheimer's disease experience psychotic symptoms, such as delusions and hallucinations. This Phase 2 trial will test whether the experimental ...

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