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Trial details imported from

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Registration number
Ethics application status
Date submitted
Date registered
Date last updated

Titles & IDs
Public title
A Definitive Estrogen Patch Study (ADEPT)
Scientific title
Multisite Double-Blind Randomized Controlled Study of Estradiol Plus Antipsychotic Versus Placebo Plus Antipsychotic in the Treatment of Psychotic Symptoms in Women With Schizophrenia
Secondary ID [1] 0 0
Secondary ID [2] 0 0
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Schizophrenia 0 0
Schizoaffective Disorder 0 0
Schizophreniform Disorder(Not in Manic Phase) 0 0
Condition category
Condition code
Mental Health 0 0 0 0
Mental Health 0 0 0 0
Psychosis and personality disorders

Study type
Description of intervention(s) / exposure
Treatment: Drugs - Estradiol
Treatment: Drugs - Estradiol
Other interventions - placebo

Active Comparator: 1 - 100 mcg Estradiol

Active Comparator: 2 - 200 mcg Estradiol

Placebo Comparator: 3 - adjunctive transdermal placebo

Treatment: Drugs: Estradiol
100 mcg adjunctive transdermal estradiol

Treatment: Drugs: Estradiol
200 mcg adjunctive transdermal estradiol

Other interventions: placebo
adjunctive transdermal placebo

Intervention code [1] 0 0
Treatment: Drugs
Intervention code [2] 0 0
Other interventions
Comparator / control treatment
Control group

Primary outcome [1] 0 0
Positive and Negative Syndrome Scale (PANSS) - The Positive and Negative Syndrome Scale (PANSS) is a well validated, standardized method of evaluating and monitoring psychotic symptoms. The PANSS assesses: positive (hallucinations, delusions, thought disorder), negative (blunted affect, abstract thinking and general symptomatology. The positive and negative subscale each consist of 7 items rated from 1(absent) - 7(extreme) with a minimum score = 7, maximum score = 49. The general subscale consists of 16 items with a minimum score = 16, maximum score = 112. A Total PANSS score (positive+ negative + general scores) has a minimum of 30 and maximum of 210. Higher scores represent more severity in symptoms.
Timepoint [1] 0 0
Baseline and week 8
Secondary outcome [1] 0 0
Cognitive Performance (RBANS Scores)
Timepoint [1] 0 0
baseline and week 8
Secondary outcome [2] 0 0
Scores on MADRS at Trial Completion
Timepoint [2] 0 0
Baseline and week 8
Secondary outcome [3] 0 0
Scores on Adverse Symptom Checklist at Trial Completion
Timepoint [3] 0 0
Baseline and weeks 1, 2, 4, 6, 8
Secondary outcome [4] 0 0
Change in Hormone Levels Over Trial Duration
Timepoint [4] 0 0
Baseline and weeks 1, 4 and 8.

Key inclusion criteria
- Female participants of potential child-bearing age (Pre-menopausal and Post-menarche)

- Female participants who meet the MINI (Mini International Neuropsychiatric Interview
for DSM-IV) diagnostic criteria for current psychotic disorder or have a current
DSM-IV diagnosis of Schizophrenia, Schizophreniform Disorder, or Schizoaffective
Disorder (not in manic phase).

- Female participants with a PANSS positive score greater than 15 and/or a PANSS
negative score greater than 15.

- Female participants who are able to give informed consent

- Female participants receiving 2-20mg daily Risperidone equivalents for at least 4
Minimum age
18 Years
Maximum age
50 Years
Can healthy volunteers participate?
Key exclusion criteria
- Female participants who are pregnant or lactating.

- Female participants with known severe abnormalities in the hypothalamo-pituitary
gonadal axis, thyroid dysfunction, central nervous system tumours, history of
thromboembolic disorders, severe renal failure, severe hepatic failure, cardiac
disease, epilepsy or other serious medical conditions which would contraindicate
estrogen use.

- Female participants already taking oral estrogen preparations containing greater then
30mcg estradiol.

- Post-menopausal or pre-menarche female participants.

- Female participants whose psychotic illness meets DSM-IV criteria for
substance-induced psychotic disorder.

- Female participants who have a current diagnosis of Schizoaffective Disorder and are
in a manic phase.

Study design
Purpose of the study
Allocation to intervention
Randomised controlled trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Masking / blinding
Blinded (masking used)
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
Intervention assignment
Other design features
Phase 2
Type of endpoint(s)
Statistical methods / analysis

Recruitment status
Data analysis
Reason for early stopping/withdrawal
Other reasons
Date of first participant enrolment
Date of last participant enrolment
Date of last data collection
Sample size
Accrual to date
Recruitment in Australia
Recruitment state(s)
Recruitment hospital [1] 0 0
Bayside Health - The Alfred Hospital - Melbourne
Recruitment postcode(s) [1] 0 0
3181 - Melbourne

Funding & Sponsors
Primary sponsor type
The Alfred
Other collaborator category [1] 0 0
Name [1] 0 0
Stanley Medical Research Institute
Address [1] 0 0
Country [1] 0 0

Ethics approval
Ethics application status

Brief summary

To test the use of adjunctive estrogen in a 8 week, three-arm, double-blind,
placebo-controlled study in the treatment of psychotic symptoms in women with schizophrenia.


That women receiving adjunctive estrogen will demonstrate significantly greater improvements
in the symptoms of schizophrenia than women receiving adjunctive placebo.


180 women will be recruited over a three-year period across three sites. Participant will be
of potential child-bearing age (Pre-menopausal and Post-menarche) with a current diagnosis of
Schizophrenia, Schizophreniform Disorder, or Schizoaffective Disorder (not in manic
phase)according to the Mini International Neuropsychiatric Interview (MINI).


Estradiol. One third of the participants (n=60) will be randomised to receive adjunctive
100mcg Estradiol; one third of the participants (n=60) will be randomised to receive
adjunctive 200mcg Estradiol n=60; and, one third of the participants (n=60) will be
randomised to receive adjunctive placebo n=60). All patches will be covered with identical
adhesive contact to ensure the "blind" is maintained.


Data will be collected over a two-month period for each participant. Visits will be performed
at baseline, and then at weekly or fortnightly intervals. A total of six visits will be
completed for each participant. The following evaluations will be performed:

i) Inclusion/exclusion checklist. (Baseline visit only)

ii) Informed consent. (Baseline visit only)

iii)psychiatric evaluation to determine diagnosis. (Baseline visit only)

iv) General clinical evaluation including medical history, current conditions and a
non-invasive physical examination, body weight, vital signs. (Baseline and endpoint visits)

v) Medication history. (Baseline and evaluation visits)

vi) Demographics. (Baseline visits only)

vii) The primary outcome measures will be the Positive and Negative Syndrome Scale (PANSS),
which will be taken at weeks 1, 2, 4 and 8 of the trial. Cognitive testing will take place at
baseline and 8 weeks. Side effects will be assessed at weeks 1, 2, 4, 6, and 8 to measure
changes in subject's reported side effects during the trial.

viii) Laboratory tests including; Serum levels of mood stabiliser, LH, FSH, Estrogen,
Progesterone, Prolactin, DHEA,Testosterone and(Baseline and evaluation visits).
Trial website
Trial related presentations / publications
Public notes

Principal investigator
Name 0 0
Jayashri Kulkarni, MBBS, MPM, FRANZCP, PhD
Address 0 0
Bayside Health / Monash University
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for public queries
Name 0 0
Address 0 0
Country 0 0
Phone 0 0
Fax 0 0
Email 0 0
Contact person for scientific queries

Summary results
Other publications