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Patient With Schizophrenia Spectrum DisorderPhase 2DREAMS-PhenNCT07152184

Study Comparing Antipsychotic Dose Reduction vs. Maintenance Treatment in Patients With Schizophrenia Spectrum Disorder: a Personalized Medicine Approach

A Phase 2 study testing Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup in people with Patient With Schizophrenia Spectrum Disorder and NLM Classification WM 203, Psychology:Schizophrenic Psychology, run by University Hospital, Strasbourg, France.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

The objective of this study is to respond to frequent requests from patients who wish to reduce or even stop their antipsychotic treatment once they have achieved clinical stability. Read more about this study

Who is it for?
Ages 18 to 60 years
What is being tested?
Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup
Could I receive a placebo?
No, everyone receives an active treatment
How many people
288 participants
Where
No sites listed yet
Study dates
1 Oct 2026to 1 Feb 2032
Phase
Phase 2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • - Patient 18-60 years of age;
  • Patient affiliated to health insurance (beneficiary or beneficiary's family);
  • Patient informed of the results of the preliminary medical examination;
  • Patient able to understand the aims and risks of the research (assisted by his/her curator, if applicable (if subject under curatorship*))
  • Informed consent signed by patient
  • Patient with a diagnosis of schizophrenia spectrum disorder (SSD): schizophrenia, schizophreniform, schizoaffective disorder or brief psychotic episode according to DSM-5;
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  • Patient with:
  • Either a cycloid psychosis (CP) phenotype according to By-CP (score >=80%)
  • Or another (non-CP) psychotic phenotype; (By-CP score < 80%)
  • Outpatient followed by an ambulatory psychiatrist;
  • Patient with an identified caregiver, defined as a person able to support the patient for the duration of the study, spending at least 8 hours per week with the patient or having easy access to the patient per phone.
  • Patient clinically stabilized, for at least 6 months, as defined by
  • low intensity of positive symptoms, i.e. PANSS P1, P2 and P3 items < 4.
  • Patient treated with oral antipsychotics (in mono or polytherapy, with second- or first-generation antipsychotics);
  • Patients with a PSP score >70 at baseline will also be included
  • The participant agrees to follow the contraceptive requirements detailed in the protocol *Subjects under limited guardianship (i.e. French "curatelle") can participate to the study.

Who cannot join

  • - Patient hospitalized in a psychiatric ward;
  • Patient with a recent psychotic episode (during the last 6 months);
  • Patient treated with long-acting injection of antipsychotics (due to feasibility constraints and to the fact that these treatments remain essentially proposed to non-compliant patients with high risk of acute cessation and loss to follow-up);
  • Patient treated with clozapine (in mono or polytherapy - highly resistant patients, specificities of the relapses under clozapine
  • Patient considered by his psychiatrists to be at serious risk of harm to self or others (e.g. previous aggressive or suicidal behaviors); notably, a patient answering "yes" to C-SSRS suicidal ideation Type 4 or 5, having any suicidal behavior assessment within 6 months at Screening, or having been hospitalized or treated for suicidal behavior in the past 5 years before Screening. The investigator will rely on the results of the C-SSRS questionnaire completed at the time of inclusion (after consent has been signed) or previously completed as part of the patient's follow-up according to current practice.
  • Neurological or severe medical condition other than psychosis;
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  • Pregnancy (verified by urinary test at enrollment for women of childbearing potential);
  • Current breastfeeding;
  • Patient involved in another Investigational Medicinal Product trial or having participated in another investigational drug trial, in which they received the investigational drug, within 60 days
  • Patient in an exclusion period defined by another research protocol;
  • Patient under guardianship (i.e. French 'tutelle');
  • Patient with care under constraint
  • Patients deprived of freedom because of a judicial measure.
  • Inability to give the patient the written consent form (emergency situation)
  • Patients with major depressive disorder (CDSS > 5) or manic episode (DSM-5-TR)
  • Patients with any of the following signs of substance abuse:
  • Current diagnosis or history of substance use disorder and/or substance intoxication as defined in the DSM-5-TR. If the history of substance use disorder is more than 12 months before baseline, the participant may be allowed to enroll in the trial after consultation with the sponsor (Participant must also have negative urine drug screen at the screening.)
  • A positive urine screen for drugs of abuse at screening.
  • A history of alcohol consumption exceeding 2 standard drinks per day on average (1 glass is approximately equivalent to the following: beer [354 mL/12 oz], wine or sake [118 mL/4 oz], or distilled spirits [29.5 mL/1 oz] per day).
  • A positive Breathalyzer test for alcohol at screening. The investigator will screen urine for drug abuse and perform an alcohol test at the inclusion visit (after consent has been signed), and may also rely on previous results obtained in the course of patient follow-up according to standard practice.
  • The participant is a trial site employee, a site employee's immediate family member (for example, spouse, parent, child, sibling), or is in a dependent relationship with a site employee who is involved in conduct of this trial or may consent under duress.

Trial locations and contacts

No sites are listed yet. Contact the study team or a site near you to ask about taking part.

About this study

Official title: A Prospective, Randomized, and Controlled Study Comparing Two Treatment Strategies (Dose REduction of Antipsychotics vs. Maintenance Treatment) in Patients With Schizophrenia Spectrum Disorder After Stratification Based on Patients' Psychotic PHENotype: a Personalized Medicine Approach

The objective of this study is to respond to frequent requests from patients who wish to reduce or even stop their antipsychotic treatment once they have achieved clinical stability. Psychiatrists are reluctant to respond to these requests because the method for safely reducing or stopping antipsychotic treatment remains poorly understood.

The investigators want to verify the existence of an interaction between treatment strategy and psychotic phenotype (cycloid psychosis vs. non-CP), i.e., in terms of functional remission, the benefit of the dose reduction strategy compared to the maintenance strategy will be greater in the CP group than in the non-CP group.

Read more

To this end, patients will be randomly assigned to four groups based on their phenotype and treatment strategy (CP-dose reduction; CP-dose maintenance; non-CP-dose reduction; and non-CP-dose maintenance).

Several hospitals throughout France are participating in this study, in which a random draw (called randomization) will be conducted to determine whether the physician will propose reducing the antipsychotic dose or maintaining it at the same dose for the patient.

Patients included in this study will be adults aged 18 to 60 who have been diagnosed with a schizophrenic spectrum disorder (SS): schizophrenia, schizophreniform disorder, schizoaffective disorder, or brief psychotic episode.

The antipsychotics studied are:

  • second-generation antipsychotics: amisulpride, aripiprazole, olanzapine, quetiapine, risperidone;
  • first-generation antipsychotics: chlorpromazine, flupentixol, haloperidol, levomepromazine, loxapine, pipotiazine, zuclopenthixol. 288 patients will be included and followed for 24 months. The inclusion period is 48 months.

Fourteen follow-up visits are planned, every month for four months and then every two months. During these visits, self-questionnaires or cognitive tests will have to be completed by the patient, the caregiver, and/or the treating psychiatrist.

Three blood samples will be taken at inclusion, at 6 months, and at the end of the study, in particular to measure the level of medication in the blood.

Being tested
Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup
Medical subject headings
Schizophrenia Spectrum and Other Psychotic Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - FlupDrug

    Biological A blood sample of up to 5 mL will be taken at visits V0, V5, and V14, for a maximum total volume of 15 mL for the study.

    Behavioral Quality of life and disease assessment questionnaires will need to be completed by the patient and their caregiver.

Study groups in NCT07152184
Study groupRoleWhat they receive
Patients with Cycloid Psychosis receiving the Dose Reduction strategy (CP-DR)ExperimentalAfter verifying the patient's phenotype, only those with cycloid psychosis will be included in this arm. The patient's usual antipsychotic dose will be gradually reduced to doses lower than those recommended by the marketing authorization (AMM).
Receives: Drug: Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup
Patients with Cycloid Psychosis receiving the Maintenance Treatment strategy (CP-MT)Active comparatorAfter verifying the patient's phenotype, only those with cycloid psychosis will be included in this arm. The patient's usual antipsychotic dose will be maintained in accordance with those recommended by the marketing authorization (AMM).
Receives: Drug: Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup
Patients with Non-Cycloid Psychosis receiving the Dose Reduction strategy (Non-CP-DR)ExperimentalAfter verifying the patient's phenotype, only those without cycloid psychosis will be included in this arm. The patient's usual antipsychotic dose will be gradually reduced to doses lower than those recommended by the marketing authorization (AMM).
Receives: Drug: Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup
patients with Non-Cycloid Psychosis receiving the Maintenance Treatment strategy (Non-CP-MT)Active comparatorAfter verifying the patient's phenotype, only those without cycloid psychosis will be included in this arm. The patient's usual antipsychotic dose will be maintained in accordance with those recommended by the marketing authorization (AMM).
Receives: Drug: Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of patients with functional remission as defined by a Personal and Social Performance Scale score >70 (minimal 1 max 100) at 24 months follow-up (study endpoint).

    The Personal and Social Performance will be assessed at different times of the study, both by the treating psychiatrist of the patients (i.e. who is not blind to patients' treatment arm) and by the Dreams-Phen evaluation team (who will be blind to patients' treatment arm). The primary endpoint will rely ONLY on the PSP scores at 24 months assessed by the Dreams-Phen evaluation team.

    This evaluation will be performed during a webmeeting with the patient and his/her caregiver and will be based on the patient's functioning during the month preceding the evaluation.

    Measured: 24 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted3 Sep 2025
  2. Study start1 Oct 2026 (estimated)
  3. Primary completion1 Feb 2032 (estimated)
  4. Study completion1 Feb 2032 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
288 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07152184
Sponsor's protocol ID
8669
Other IDs
2023-509558-80-00, 2023
Acronym
DREAMS-Phen
Status last verified
Aug 2025
First submitted
25 Aug 2025
Last updated
26 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Berna F, Horowitz MA, Javelot H, Meyer N, Foucher JR. DREAMSPHEN: a randomised controlled study comparing dose reduction of antipsychotics vs maintenance treatment in schizophrenia spectrum disorder after stratification based on patients' psychotic phenotype - study protocol of a personalised medicine approach. BMJ Open. 2026 Jun 12;16(6):e117593. doi: 10.1136/bmjopen-2026-117593.

    PubMed 42285570

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Use of antipsychotic treatment with marketing authorization at doses lower than those recommended: - Olanzapine - Zuclopenthixol - Risperidone - Pipotiazine palmitate / Pipotiazine - Quetiapine - Flup in people with Patient With Schizophrenia Spectrum Disorder and NLM Classification WM 203, Psychology:Schizophrenic Psychology, run by University Hospital, Strasbourg, France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 16 inclusion and 21 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 26 May 2026. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Fabrice BERNA, MD (+33388116462, fabrice.berna@chru-strasbourg.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of patients with functional remission as defined by a Personal and Social Performance Scale score >70 (minimal 1 max 100) at 24 months follow-up (study endpoint). (time frame: 24 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07152184, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 May 2026.

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