Research Focus | Studies Details

Clozapine is a medication used for treatment-resistant schizophrenia in people who have tried multiple other antipsychotics without improvement in their symptoms. While the manufacturer recommends that this medication be prescribed in more than one dose a day, in practice, many people take the medication once a day in the evening because it is more convenient, and because clozapine can have side-effects such as sleepiness. This study hopes to formally examine whether there are any differences in taking this medication once a day versus twice a day in a trial with people currently taking clozapine twice daily. Half of the participants will be randomized to take a placebo pill in the morning and clozapine at night, while the other half will continue to take their clozapine twice a day.

This study is designed to evaluate the safety and efficacy of NaBen® (sodium benzoate) in combination with clozapine in improving the residual symptoms of refractory schizophrenia in adults. NaBen® (sodium benzoate) is a DAAO inhibitor with a well-developed safety profile. Sodium benzoate is the sodium salt of benzoic acid and is usually available in a white, dry powder form. Sodium benzoate is a food preservative approved by the WHO, USA, EU, Japan, and Taiwan. In this phase II/III, double-blind study, eligible patients will be randomized (1:1:1) to receive either NaBen® 2000 mg/day, NaBen® 1000 mg/day or placebo adjunctively to their current clozapine treatment. Total study participation will last 12 weeks, which includes 6 clinic visits and one follow-up phone call 14 days after the last clinic visit.

The purpose of this trial is to test whether a new investigational drug, called BI 425809, when taken while completing Computerized Cognitive Training (brain-training using a computer), may improve cognitive functioning in patients with schizophrenia. Some of the participants in this study will get BI 425809 and others will receive a placebo (a substance that looks like the investigational drug but does not have any active or medicinal ingredients). The placebo in this study is not intended to have any effects on your cognitive functioning. A placebo is used to make the results of the study more reliable. There will be 7 in-person visits.

This study examines whether people who take certain schizophrenia medications can be switched to taking them every other day without a loss in clinical response. Several benefits to this approach were seen in a similar pilot study, with people reporting no worsening of schizophrenia symptoms and subjective improvement in side-effects. An added effect of alternate day dosing is that medication costs would be halved. This trial looks to examine this dosing regimen on a larger scale with a placebo control group and with researchers, as well as participants blinded to whether they are in the placebo group or the treatment group.

This study is designed to evaluate the safety and efficacy of NaBen® (sodium benzoate) in improving the symptoms of schizophrenia in adults. NaBen® (sodium benzoate) is a DAAO inhibitor with a well-developed safety profile. Sodium benzoate is the sodium salt of benzoic acid and is usually available in a white, dry powder form. Sodium benzoate is a food preservative approved by the WHO, USA, EU, Japan and Taiwan. In this double-blind study, eligible patients will be randomized (1:3) to receive either NaBen® or a placebo adjunctively to their current antipsychotic. Total study participation will last 68 weeks, which includes 12 clinic visits and one follow-up phone call 14 days after the last clinic visit.

Schizophrenia is a chronic illness. People suffering from serious mental illness such as psychosis or schizophrenia may often be at a disadvantage when managing weight and are at an increased risk of cardiovascular risk factors. While approximately 70% of individuals with first episode psychosis respond well to antipsychotic drugs, there is a group who experience persistent psychotic symptoms. This group of patients is often prescribed clozapine, due to its superior ability to treat those who are non-responsive to other antipsychotics, despite clozapine’s increased likelihood of weight gain and cardiovascular risk. Our study seeks to determine if the drug Topiramate, an anti-seizure and anti-migraine medication, can reduce this weight gain and cardiovascular risk that is associated with taking clozapine.

This study examines the use of a medication called semaglutide, and whether it can help patients with schizophrenia who are taking antipsychotics to lose weight and improve other metabolic side effects that they may have experienced from their current medication.

Antipsychotic medications are known to put people at risk for weight gain, diabetes and heart disease, but the medications have not been well studied in young adults who are starting the medication for the first time. Additionally, there is little known about how antipsychotic medications impact the gut bacteria of young people when medications are started for the first time. This study’s goal is to examine the impact of these medications on the gut microbiome, glucose levels, and weight, as well as attention and memory.

Insulin is a hormone in the body that controls sugar levels by lowering the amount of glucose produced by the liver. Within the brain, insulin has been shown to change the way that the brain processes information. This change in brain cognitive ability may also occur when taking antipsychotic medications. This study looks to understand the relationship between brain insulin activity and antipsychotic medications on these cognition-related effects. This may help us to better understand the effects of antipsychotic drugs on the brain and its ability to process insulin.

Major depressive disorder in adolescence is linked with poorer cardiovascular and metabolic outcomes later in life, such as an increased risk of developing type 2 diabetes. Insulin is a hormone in the body that controls sugar levels by lowering the amount of glucose that is produced by the liver. Within the brain, insulin has been shown to change the way that the brain processes information and higher brain insulin resistance is associated with worse cognitive ability and depressive symptoms. This study looks at the relationship between brain insulin resistance and major depressive disorder in adolescents who have not yet started antidepressant medications.

People with schizophrenia have a high rate of suicidal behavior, and this study contributes to identifying potential biological predictors of suicidal behavior. The study compares two groups of people: those who have attempted suicide at least twice before and those who have never had suicidal thoughts or attempted suicide. This study focuses on the differences in brain structure, brain function and genetics. Eligible participants may undergo an MRI scan, and provide blood or saliva samples.

This study examines whether genetics contribute to some people developing a serious heart condition called myocarditis as a side effect of taking clozapine, a medication used to treat schizophrenia. In addition, it also uses stem cell technology to investigate how this might occur. Identification of a clinically useful marker for clozapine-induced myocarditis would contribute to better monitoring and prevention of these side-effects in people taking clozapine.

Antipsychotic medications can work well for some people with schizophrenia, but they may not help others with the same illness. It is important to understand the reasons for different antipsychotic treatment responses within individuals with schizophrenia. This study explores whether certain brain chemicals play a role in antipsychotic medication working effectively. Knowing how brain chemicals are related to antipsychotic treatment response can lead to the development of more effective treatments in the future.

Approximately 20% to 35% of patients show partial or no response to antipsychotic treatment. Clozapine is commonly used when people have treatment-resistant schizophrenia. In this study, we are examining patients' brain chemical changes after they begin clozapine to better understand how this medication works. This can help create new strategies and treatments for patients who do not respond well to antipsychotic treatment.

This project explores whether a treatment called intermittent theta burst stimulation, or iTBS, can help improve social skills. Sometimes people who have experienced symptoms of psychosis have difficulties with social functioning, and this research study may help with these difficulties. iTBS, is a form of repetitive transcranial magnetic stimulation (rTMS), that uses magnetic pulses to activate the part of the brain that is responsible for social skills. It’s safe, effective, and past studies have shown improvement in attention, memory, and depressive symptoms. 

When people do not take their medications regularly, it can lead to a significant increase in unwanted symptoms and problems. This study explores whether a non-invasive treatment called tDCS, or transcranial Direct Current Stimulation, can help with medication-taking habits in individuals with schizophrenia. Improving adherence to medication could have a positive impact on the management of mental health symptoms.

Electroretinography (ERG) is a non-invasive test that measures the electrical response of the retina. The purpose of this study is to assess ERG components which can differentiate patients with schizophrenia (SZ) and bipolar disorder type I (BPI) in prediction models. Findings from the study will define the most relevant ERG components in patients diagnosed with SZ or BPI versus control subjects, and identify those to be considered in differentiating between SZ and BPI.

This study combines virtual reality training with transcranial direct current stimulation (tDCS). The virtual reality training program involves using a controller to navigate through a virtual city. tDCS is a safe and well-tolerated non-invasive brain stimulation. The study aims to see if these combined treatments will help with motivation, low interest and emotion expression. To better understand how the treatment works, we will be taking images of your brain, with MRI, before you start the treatment and again after you complete the treatment.

This study combines virtual reality training with transcranial direct current stimulation (tDCS) for youth at clinical high-risk for psychosis. The virtual reality training program involves using a controller to navigate through a virtual city. tDCS is a safe and well-tolerated non-invasive brain stimulation. The study aims to see if these combined treatments will help with motivation, low interest and emotion expression. To better understand how the treatment works, we will be taking images of your brain, using MRI, before you start the treatment and again after you complete the treatment.

Electroretinography (ERG) is a non-invasive test that measures the electrical response of the retina. The purpose of this study is to assess ERG components which can differentiate patients with schizophrenia (SZ) and bipolar disorder type I (BPI) in prediction models. Findings from the study will define the most relevant ERG components in patients diagnosed with SZ or BPI versus control subjects, and identify those to be considered in differentiating between SZ and BPI.

The goal of this project is to evaluate a potential serum biomarker to predict who will develop schizophrenia. We previously showed that a protein complex composed of DISC1 (Disrupted-in-schizophrenia 1) and the dopamine D2 receptor (D2R) is elevated in post-mortem brain tissue from schizophrenia patients. We then developed a peptide that disrupts the Disc1-D2R protein complex, and normalizes behaviours related to schizophrenia in animal models. In the current study we hope to recruit patients early in the development of psychosis to see if the protein complex is elevated and whether this predicts a later diagnosis of schizophrenia. This could then be used as an early diagnostic test.

This research study is being conducted to find out more about the effectiveness of a therapy that combines Executive Function Training with Cognitive-Behavioural Social Skills Training (E-CBSST). Executive function is a set of mental skills that include working memory, flexible thinking, and self-control. We use these skills every day to learn, work, and manage daily life. Trouble with executive function can make it hard to focus, follow directions, and handle emotions, among other things. E-CBSST includes computerized cognitive training and skills training with a therapist to improve skills learning and daily-role functioning. 

The two interventions - Executive Function Training and Cognitive-Behavioural Social Skills Training - are previously tested and validated interventions. This study will test whether the combination of the two interventions will further increase skills learning.

This study aims to understand everyday functioning and recovery pathways for individuals living with mental health concerns like psychosis. This can help us better understand how to support people with these disorders later on, and improve treatments. This study consists of 7 visits at CAMH which will happen every 6 months for the next 3 years. During your study visits, you will do some questionnaires and provide blood/saliva samples. Some visits will be completed in person, while some can also be done remotely. There is also an opportunity to have an MRI scan.

Although antipsychotic and antidepressant medications provide tremendous relief to many individuals, a substantial minority of people are considered to have “treatment-vresistant” (TR) forms of schizophrenia and depression. And while the TR label is used in a variety of psychiatric illnesses, “treatment resistant” is a divergent and shifting concept, between and within given disorders. This project will map the terrain of TR across depression and schizophrenia—two psychiatric disorders where TR is most prominently employed—while exploring the impact of the language and methods embedded within the TR concept on the lived experience of people categorized with the TR label.

Treatment engagement and fostering illness self-management are very challenging areas in schizophrenia care. Digital health (dHealth) technology is a promising but largely unexplored and under-studied resource in schizophrenia care compared to dHealth advances in areas. dHealth is particularly salient given its reach, accessibility, low cost and increasing relevance to younger schizophrenia populations — most of whom use mobile technologies. This trial is examining the feasibility of a mobile technology designed to enhance illness self-management and treatment engagement for individuals with schizophrenia-spectrum illnesses.

This project aims to develop a culturally adapted form of psychotherapy for South Asian populations living in Canada. South Asians make up the largest racialized group in Canada but are disproportionately affected by higher rates of anxiety and mood disorders such as depression and anxiety. Cognitive Behavioral Therapy (CBT) is an evidence-based psychological treatment that has been proven to help people who are experiencing mental health concerns. By consulting with various stakeholders, including individuals with lived experience and mental health professionals, the goal of this study is to culturally adapt CBT for Canadians of South Asian origin, and test its acceptability and effectiveness in this population. This study will be the first in North America to develop and test culturally adapted CBT with the hopes of improving both outcomes and access for South Asian Canadians experiencing anxiety and depression.

Given that within five years of remission, up to 80% of individuals diagnosed with schizophrenia will relapse, identifying an early intervention to prevent recurrence in this population is critical. Speech and language disturbances are a defining feature of psychosis, and thus can be utilized as a biomarker to predict relapse. Notably, research reveals that artificial intelligence (AI) algorithms that use speech characteristics have an 80% accuracy in predicting the onset of first-episode psychosis. In partnership with Winterlight Labs Inc., this project seeks to investigate the feasibility and acceptability of a mobile phone speech application to analyze these speech features with the goal of predicting relapse in youth who have previously been diagnosed with Schizophrenia Spectrum Disorders (SSD).

This project has explored the tensions, nuances, ambiguities and contradictions that exist within the lived experience of psychosis from the perspectives of first-episode psychosis service users, their family members and their care teams. Using ethnographic and arts-based methods, we have examined unintended consequences, challenges and frictions that emerge in the clinical setting, and have looked at the ways in which first-episode services, along with the experience of psychosis itself, impact service users' self-understanding, their relationships, and roles in their families and communities.

We examined the effectiveness of a brief intervention that might better facilitate the transition into the community for people with schizophrenia – one that has in preliminary research been found feasible and associated with positive outcomes. The intervention is called the Welcome Basket. It involves Peer Support Workers (individuals with lived experience of mental illness working as supports) who connect with hospitalized individuals in the days before discharge and again in the community in the weeks immediately following discharge. This study was one of the most rigorous examinations of peer support and transitional interventions and provided important information to the field regarding how care at this critical time needs to be designed and considered.