Use of Galantamine and CDP-choline (Citicoline) to Treat Adults With Schizophrenia

Schizophrenia is a life-long brain disorder affecting approximately 1 percent of Americans
each year. Schizophrenia can be extremely disabling, causing people to hear voices,
experience paranoia or hallucinations, believe that others are controlling their thoughts,
and even fail at maintaining a job or caring for themselves. Current medications help to
relieve most of these negative symptoms, but not all. Many people with schizophrenia still
suffer from low energy levels, an inability to concentrate, and memory loss. Galantamine is a
medication that is used to improve memory and energy levels in people with Alzheimer's
disease, and CDP-choline is a nutritional supplement. The purpose of this study is to
evaluate the effectiveness of adding galantamine and CDP-choline to a stable anti-psychotic
medication regimen of risperidone as a way of improving symptoms in adults with
schizophrenia.

Participants in this double-blind study will attend an initial screening during which they
will undergo a physical exam, an electrocardiogram, and blood and urine collection.
Participants will then be randomly assigned to receive galantamine and CDP-choline or a
placebo treatment for 16 weeks. Participants assigned to the treatment group will take 500 mg
of CDP-choline daily for the first 3 days, 1,000 mg daily for the next 4 days, and 2,000 mg
daily for the following 15 weeks. Participants assigned to the treatment group will also take
8 mg of galantamine daily for the first week, 16 mg daily for the next week, and 24 mg daily
for the following 14 weeks. Participants assigned to the control group will take two types of
placebo pills every day for 16 weeks. All participants will continue to take their regular
regimen of risperidone, olanzapine, quetiapine, ziprasidone, and/or aripiprazole throughout
the trial in addition to their assigned treatment. Staff members will meet with participants
during the first week of the study and every 4 weeks afterward until study completion. During
these meetings, participants will identify any side effects, report nicotine intake, breathe
into a machine that measures the amount of nicotine in the body, and complete written and
computerized tasks on concentration and memory. Each meeting may last up to 3 hours. On the
last week of the study, blood and urine samples will be collected and an electrocardiogram
will be administered. Results from this study will be used to evaluate whether CDP-choline
and galantamine improve schizophrenia symptoms.

CDP-choline and matching placebos were purchased from LifeLink Corporation. Galantamine and
matching placebos were prepared and donated by Ortho McNeil Janssen Scientific Affairs LLC.

Inclusion Criteria:

- Meets DSM-IV criteria for schizophrenia or schizoaffective disorder

- Eligible for care within the Veterans Affairs Medical system

- Taking risperidone, olanzapine, quetiapine, ziprasidone, and/or aripiprazole (oral or
injection)

Exclusion Criteria:

- Significant liver, kidney, lung, endocrine, active peptic ulcer, or cardiovascular
disease

- Seizure disorder and/or head injury

- Substance use or abuse within 3 months of study entry

- Pregnant