Antipsychotic Treatment of very LAte-onset Schizophrenia –like psychosis (ATLAS)
Very late-onset (i.e. onset >60yrs) schizophrenia-like psychosis is a common condition, which affects an estimated 34,000 of the UK population and with 2,800 new service contacts each year. Impairments in quality of life associated with psychosis are severe. Patients often suffer the effects of their delusional beliefs for many years and this has a negative impact upon their families, neighbours and local social and housing services. ATLAS is a randomised double-blind trial designed to determine whether amisulpride is superior to placebo in the treatment of very late-onset schizophrenia-like psychosis, and whether prolonging amisulpride for a further 24 weeks after an initial 12 week treatment period confers additional benefits. The primary outcome measures are change in the Brief Psychiatric Rating Scale (BPRS) and the proportions who discontinue treatment because of a perceived lack of efficacy. ATLAS will also assess side-effects, safety, treatment compliance, the effects on quality of life and the cost-effectiveness of amisulpride treatment.
Why carry out the research?
Antipsychotic drugs are widely used to treat very late-onset schizophrenia-like psychosis but this practice is not evidence- based. A Cochrane review concludes that there is no reliable clinical trial evidence on which to base treatment guidelines. Therefore a large randomised trial is urgently needed to reliably assess the balance of benefits and risks of antipsychotic use in late-onset schizophrenia-like psychosis and inform treatment guidelines.
How is the research being undertaken?
ATLAS is a pragmatic, randomised, 3 arm, double-blind placebo-controlled trial with two stages. All patients who participate in the ATLAS trail will receive at least 12 weeks of the active treatment. Baseline measures are recorded and repeated at 4/12, 10-12/52 and 34-36 weeks.
Stage 1- weeks 1-12 Stage 2-weeks 13-36
a) Amisulpride 100mg (n=100)………………………..Amisulpride 100mg
b) Amisulpride 100mg (n=100)………………………..Placebo
c) Placebo (n-100)………………………………………….. Amisulpride 100mg
Where is it happening?
Atlas is a national study. At present 32 sites are involved across England and Scotland and others may join in the future.
Who is involved?
The ATLAS study was developed and is being organised by a group of researchers from the Universities of London and Oxford. The Chief Investigator is Professor Robert Howard based at the Department Of Old Age Psychiatry, Institute of Psychiatry, London. The funding to conduct the ATLAS trial is provided by the NIHR Health Technology programme and the sponsor is King’s College London.
What is the timescale?
The project is due to finish in 2016
Professor Robert Howard (CI) 020 7848 0545 firstname.lastname@example.org
Liz Cort (Atlas Research Nurse) 020 78480024 email@example.com