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Bipolar Disorder INCT05705063

Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Bipolar Illness

A study testing LCHF Ketogenic Diet in people with Bipolar Disorder I and Bipolar II Disorder, run by Stanford University at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

To initiate a low-carbohydrate, high-fat (LCHF) or ketogenic dietary (KD) intervention among a cohort of outpatients with bipolar illness who also have metabolic abnormalities, overweight/obesity, and/or are currently taking psychotropic medications experiencing metabolic side effects. Read more about this study

Who is it for?
Ages 18 to 75 years
What is being tested?
LCHF Ketogenic Diet
Could I receive a placebo?
No, everyone receives an active treatment
How many people
30 participants
Where
1 siteUnited States
Study dates
30 Jan 2023to 30 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female, 18 to 75 years of age.
  • Able to provide informed consent.
  • Meet DSM V criteria for diagnosis with Bipolar Disorder (BPD), any subtype, for > 1 year and clinically stable (with no hospitalization for past 3 months)
  • Participants may currently be on a stable and adequate dose of SSRI antidepressant therapy or other psychiatric medications. Concurrent hypnotic therapy (e.g., with zolpidem, zaleplon, melatonin, or trazodone) will be allowed if the therapy has been stable for at least 4 weeks prior to screening and if it is expected to remain stable. Participants may choose to not be on antidepressant therapy for the study duration, or to be switched from other classes to a medication from the SSRI class.
  • currently taking SSRI or psychotropic medication and gained at least 5% weight since starting medication or have a BMI greater than or equal to 26 kg/m2 or presence of at least one metabolic abnormality (hypertriglyceridemia, insulin resistance, dyslipidemia, impaired glucose tolerance)
  • In good general health, as ascertained by medical history.
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  • If female, a status of non-childbearing potential or use of an acceptable form of birth control. The form of birth control will be documented at screening and baseline.
  • willing to consent to all study procedures and attend follow-up appointments and motivated to follow dietary program.
  • Sufficient control over their food intake to adhere to study diets.
  • willingness to regularly monitor blood pressure, glucose, dietary intake, and body weight over 6-week trial

Who cannot join

  • Female of childbearing potential who is not willing to use one of the specified forms of birth control during the study.
  • Female that is pregnant or breastfeeding.
  • Female with a positive pregnancy test at participation.
  • comorbidity of developmental delay or Cognitive impairment (as noted by previous diagnoses-including dementia).
  • Current diagnosis of a Substance Use Disorder (Abuse or Dependence, as defined by DSM-IV-TR), with the exception of nicotine dependence, at screening or within six months prior to screening.
  • History of positive screening urine test for drugs of abuse at screening: cocaine, amphetamines, barbiturates, opiates.
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  • Current (or chronic) use of opiates.
  • in a current severe mood or psychotic state when entering the study that would prohibit compliance with study visits or dietary program.
  • Considered at significant risk for suicide during the course of the study.
  • any one who has been hospitalized or taken clozapine at doses above 550mg over the past 3 months
  • Has a clinically significant abnormality on the screening examination that might affect safety, study participation, or confound interpretation of study results.
  • Any current or past history of any physical condition which in the investigator's opinion might put the subject at risk or interfere with study results interpretation.
  • Participation in any clinical trial with an investigational drug or device within the past month or concurrent to study participation.
  • inability to complete baseline measurements
  • severe renal or hepatic insufficiency
  • cardiovascular dysfunction, including diagnosis of:
  • Congestive heart failure
  • Angina
  • Arrhythmias
  • Cardiomyopathy
  • Valvular heart disease
  • History of cardiovascular disease or cardiac event.
  • any other medical condition that may make either diet dangerous as determined by the study medical team (e.g. anorexia nervosa)

Trial locations and contacts

1 site in 1 country.

Diane E Wakeham, PhD contact

650-736-5243

wakeham@stanford.edu

Shebani Sethi, MD contact

650-721-4419

shebanis@stanford.edu

United States1 site
  • Stanford University School of Medicine

    Stanford, California, 94704

    Diane E Wakeham, PhD, 650-736-5243, wakeham@stanford.edu

    Study Coordinator, 650-736-5243

Other trials in United States

About this study

Official title: Impact of A Low-Carbohydrate, High-Fat, Ketogenic Diet on Obesity, Metabolic Abnormalities, and Psychiatric Symptoms on Patients With Bipolar Disorder (BPD)

To initiate a low-carbohydrate, high-fat (LCHF) or ketogenic dietary (KD) intervention among a cohort of outpatients with bipolar illness who also have metabolic abnormalities, overweight/obesity, and/or are currently taking psychotropic medications experiencing metabolic side effects.

Read the detailed description

Adults with mental illness represent a high-risk, marginalized group in the current metabolic and obesity epidemic. Among US adults with severe mental illness, metabolic syndrome are highly prevalent conditions having severe consequences, with patients estimated to die on average 25 years earlier than the general population largely of premature cardiovascular disease. Many psychiatric medications, particularly neuroleptics and mood stabilizers, may, in addition, contribute to metabolic side effects and weight gain. Low-carbohydrate high-fat (LCHF) or ketogenic diets (KD) have been shown to reduce cardiovascular risk in those with insulin resistance. Recent findings support the idea that bipolar disorder may have roots of metabolic dysfunction: cerebral glucose hypometabolism, oxidative stress, as well as mitochondrial and neurotransmitter dysfunction which has downstream effects on synapse connections. A KD diet provides alternative fuel to the brain aside from glucose and is believed to contain beneficial neuroprotective effects, including stabilization of brain networks, reduction of inflammation and oxidative stress. The purpose of this study is to evaluate both the metabolic and psychiatric outcomes with a KD diet in this psychiatric population.

Being tested
LCHF Ketogenic Diet
Medical subject headings
Bipolar Disorder, Bipolar and Related Disorders, Obesity, Metabolic Syndrome, Weight Gain, Brain Diseases, Metabolic

What participants receive

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

  • LCHF Ketogenic DietOther

    Low Carbohydrate, Moderate Protein, High Fat Ketogenic Dietary Intervention 6 weeks

Study groups in NCT05705063
Study groupRoleWhat they receive
Bipolar PatientsExperimentalPatients follow ketogenic diet for 16 weeks, with monitoring of physical and psychological health and coaching support
Receives: Other: LCHF Ketogenic Diet

What is being measured

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

  1. Change in Weight from Baseline

    Weight recorded weekly during study

    Measured: Baseline, 6 weeks

  2. Change in Waist Circumference from Baseline

    Waist circumference recorded at each visit during study

    Measured: Baseline, 6 weeks

  3. Change in Heart Rate from Baseline

    Heart rate recorded at each visit during study

    Measured: Baseline, 6 weeks

  4. Change in Blood Pressure from Baseline

    Blood pressure recorded weekly during study

    Measured: Baseline, 6 weeks

  5. Change in Visceral Fat Mass from Baseline

    Kg visceral fat in body composition (SECA or Inbody) recorded 2-3 times during study

    Measured: Baseline, 6 weeks

  6. Change in Body Fat Mass from Baseline

    Kg body fat in body composition (SECA or Inbody) recorded 2-3 times during study

    Measured: Baseline, 6 weeks

  7. Change in Hemoglobin A1c from Baseline

    Blood measurement of Hemoglobin A1c recorded at baseline and study end

    Measured: Baseline, 6 weeks

  8. Change in Insulin Resistance Measure (HOMA-IR) from Baseline

    HOMA-IR calculated from blood measurements recorded at baseline and study end

    Measured: Baseline, 6 weeks

  9. Change in Inflammatory Marker (hs-CRP) from Baseline

    Blood measurement of hs-CRP recorded at baseline and study end

    Measured: Baseline, 6 weeks

  10. Change in Lipid Profile (TG) from Baseline

    Blood levels of Lipid Triglycerides (TG) recorded at baseline and study end

    Measured: Baseline, 6 weeks

  11. Change in Lipid Profile small LDL from Baseline

    Blood levels of small, low density lipoprotein cholesterol (LDL-C) recorded at baseline and study end

    Measured: Baseline, 6 weeks

  12. Change in Lipid Profile HDL from Baseline

    Blood levels of high density lipoprotein cholesterol (HDL-C) recorded at baseline and study end

    Measured: Baseline, 6 weeks

Secondary outcomes (8)
  1. Change in Clinical Mood Monitoring from Baseline

    Change in Clinical Mood Monitoring Psychiatric Index from Baseline

    Measured: Baseline, 6 weeks

  2. Change in Clinical Global Impression from Baseline

    Change in Clinical Global Impression (CGI) Psychiatric Index from Baseline; 1-7 scale. (1= not at all ill, 7= among the most extremely ill patients)

    Measured: Baseline, 6 weeks

  3. Change Generalized Anxiety Disorder from Baseline

    Change in General Anxiety Disorder (GAD-7) scale from Baseline. 0-15+ scale. (0= no anxiety, 15+= severe anxiety)

    Measured: Baseline, 6 weeks

  4. Change in Depression from Baseline

    Change in Depression on Patient Health Questionnaire (PHQ-9) scale from Baseline; Score range 0-27 (0= no depression, 27= severe depression)

    Measured: Baseline, 6 weeks

  5. Change in Global Assessment of Functioning from Baseline

    Change in Global Assessment of Functioning (GAF) scale from baseline; 1-100 scale (1= persistent danger of hurting self or others, 100= superior functioning)

    Measured: Baseline, 6 weeks

  6. Change in Quality of Life from Baseline

    Change in Manchester Quality of Life (MANSA) scale from baseline; Range 12-84 (each of 12 outcomes rated from 1= could not be worse to 7= could not be better; <4= dissatisfied with QoL, >4= satisfied with QoL)

    Measured: Baseline, 6 weeks

  7. Change in Quality of Sleep from Baseline

    Change in Pittsburgh Sleep Quality Index (PSQI) from baseline; 0-21 scale (<5=good sleeper; 5+= meaningfully disturbed sleep or poor sleeper)

    Measured: Baseline, 6 weeks

  8. Change in Eating Behavior from Baseline

    Change in Binge Eating Scale (BES) from Baseline; 0-46 scale (<17 minimal binge eating problems, >27 severe binge eating problems)

    Measured: Baseline, 6 weeks

Timeline

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

  1. First posted30 Jan 2023
  2. Study start30 Jan 2023 (estimated)
  3. Primary completion30 Jun 2024 (estimated)
  4. Study completion30 Dec 2024 (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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Single Group Assignment
Masking
None (open label)
Enrolment
30 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05705063
Sponsor's protocol ID
68493
Status last verified
Jan 2023
First submitted
21 Jan 2023
Last updated
30 Jan 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Carmen M, Safer DL, Saslow LR, Kalayjian T, Mason AE, Westman EC, Sethi S. Treating binge eating and food addiction symptoms with low-carbohydrate Ketogenic diets: a case series. J Eat Disord. 2020 Jan 29;8:2. doi: 10.1186/s40337-020-0278-7. eCollection 2020.

    PubMed 32010444
  • Norwitz NG, Sethi S, Palmer CM. Ketogenic diet as a metabolic treatment for mental illness. Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):269-274. doi: 10.1097/MED.0000000000000564.

    PubMed 32773571
  • Brietzke E, Mansur RB, Subramaniapillai M, Balanza-Martinez V, Vinberg M, Gonzalez-Pinto A, Rosenblat JD, Ho R, McIntyre RS. Ketogenic diet as a metabolic therapy for mood disorders: Evidence and developments. Neurosci Biobehav Rev. 2018 Nov;94:11-16. doi: 10.1016/j.neubiorev.2018.07.020. Epub 2018 Jul 31.

    PubMed 30075165
  • Unwin J, Delon C, Giaever H, Kennedy C, Painschab M, Sandin F, Poulsen CS, Wiss DA. Low carbohydrate and psychoeducational programs show promise for the treatment of ultra-processed food addiction. Front Psychiatry. 2022 Sep 28;13:1005523. doi: 10.3389/fpsyt.2022.1005523. eCollection 2022.

    PubMed 36245868
  • Danan A, Westman EC, Saslow LR, Ede G. The Ketogenic Diet for Refractory Mental Illness: A Retrospective Analysis of 31 Inpatients. Front Psychiatry. 2022 Jul 6;13:951376. doi: 10.3389/fpsyt.2022.951376. eCollection 2022.

    PubMed 35873236
  • Sethi S, Ford JM. The Role of Ketogenic Metabolic Therapy on the Brain in Serious Mental Illness: A Review. J Psychiatr Brain Sci. 2022;7(5):e220009. doi: 10.20900/jpbs.20220009. Epub 2022 Oct 31.

    PubMed 36483840
  • Imdad K, Abualait T, Kanwal A, AlGhannam ZT, Bashir S, Farrukh A, Khattak SH, Albaradie R, Bashir S. The Metabolic Role of Ketogenic Diets in Treating Epilepsy. Nutrients. 2022 Nov 29;14(23):5074. doi: 10.3390/nu14235074.

    PubMed 36501104
  • Sethi S, Sinha A, Gearhardt AN. Low carbohydrate ketogenic therapy as a metabolic treatment for binge eating and ultraprocessed food addiction. Curr Opin Endocrinol Diabetes Obes. 2020 Oct;27(5):275-282. doi: 10.1097/MED.0000000000000571.

    PubMed 32773576

Questions about this trial

What is this clinical trial studying?

A study testing LCHF Ketogenic Diet in people with Bipolar Disorder I and Bipolar II Disorder, run by Stanford University at 1 site in United States.

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 10 inclusion and 23 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: status not confirmed, as of the sponsor's last update on 30 Jan 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

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.

Are results available for this study?

Results are not available in the source record.

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

Contact Diane E Wakeham, PhD (650-736-5243, wakeham@stanford.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Weight from Baseline (time frame: Baseline, 6 weeks). The study lists 12 primary outcomes in all. 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 NCT05705063, which also lists 8 linked publications.

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 30 Jan 2023.

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