4006-776-356 出国就医服务电话

免费获得国外相关药品，最快 1 个工作日回馈药物信息

出境医 / 临床实验 / Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Schizophrenia or Bipolar Illness

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

Study Description
Brief Summary:

To initiate a low-carbohydrate, high-fat (LCHF) ketogenic dietary intervention among a small cohort of outpatients with either schizophrenia or bipolar illness and comorbid overweight/obesity currently taking psychotropic medications.

Adults with mental illness represent a high-risk, marginalized group in the current obesity epidemic. Among US adults with severe mental illness, obesity and overweight 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. In addition, many psychiatric medications, particularly antipsychotics and mood stabilizers, can contribute to metabolic side effects and weight gain. Low-carbohydrate high-fat (LCHF) diets have been shown to reduce cardiovascular risk in those with insulin resistance. The purpose of this study is to evaluate both the metabolic and psychiatric outcomes with an LCHF diet in this psychiatric population.


Condition or disease Intervention/treatment Phase
Obesity Ketogenic Dieting Metabolic Syndrome Bipolar Disorder Schizophrenia Weight Gain Psychotropic Drug, Unspecified Causing Adverse Effects in Therapeutic Use Other: LCHF, Ketogenic Diet Not Applicable

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 20 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Impact of A Low-Carbohydrate, High-Fat, Ketogenic Diet on Obesity, Metabolic Abnormalities and Psychiatric Symptoms in Patients With Schizophrenia or Bipolar Illness: An Open Pilot Trial
Actual Study Start Date : February 13, 2019
Estimated Primary Completion Date : December 2021
Estimated Study Completion Date : December 2021
Arms and Interventions
Arm Intervention/treatment
Experimental: Ketogenic Diet 16 Week Group Other: LCHF, Ketogenic Diet
Low Carbohydrate, Moderate Protein, High Fat Ketogenic Dietary Intervention 16 weeks
Outcome Measures
Primary Outcome Measures :
  1. Change in heart rate from baseline [ Time Frame: Baseline, 16 weeks ]
  2. Change in blood pressure from baseline [ Time Frame: Baseline, 16 weeks ]
  3. Change in weight from baseline [ Time Frame: Baseline, 16 weeks ]
  4. Change in body fat mass from baseline [ Time Frame: Baseline, 16 weeks ]
  5. Percent Change in Hemoglobin A1c from baseline [ Time Frame: Baseline, 16 weeks ]
  6. Change in insulin resistance measure (HOMA-IR) from baseline [ Time Frame: Baseline, 16 weeks ]
  7. Change in inflammatory marker (hsCRP) from baseline [ Time Frame: Baseline, 16 weeks ]
  8. Change in lipid profile (triglycerides) from baseline [ Time Frame: Baseline, 16 weeks ]
  9. Change in lipid profile (small dense LDL) from baseline [ Time Frame: Baseline, 16 weeks ]
  10. Change in lipid profile (HDL) from baseline [ Time Frame: Baseline,16 weeks ]

Secondary Outcome Measures :
  1. Psychiatric Indices - Mood [ Time Frame: Baseline, 16 weeks ]
    Change in Mood Score (Clinical Mood Monitoring) from baseline

  2. Psychiatric Indices- Clinical Global Impression [ Time Frame: Baseline, 16 weeks ]
    Change in Clinical Global Impression Scales (CGI) from baseline

  3. Psychiatric Indices- Global Assessment of Functioning [ Time Frame: Baseline, 16 weeks ]
    Change in Global Assessment of Functioning (GAF) Scale from baseline

  4. Psychiatric Indices- Quality of Life [ Time Frame: Baseline, 16 weeks ]
    Change in Manchester Quality of Life Scale (MANSA) from baseline

  5. Psychiatric Indices- BPRS [ Time Frame: Baseline, 16 weeks ]
    Change in Brief Psychiatric Rating Scale (BPRS) from baseline


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   18 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  1. Age 18-70 years old
  2. Meet DSM V criteria for schizophrenia or bipolar disorder, any subtype, for > 1 year and clinically stable (with no hospitalization for past 3 months)
  3. Currently taking 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)
  4. Willing to consent to all study procedures and attend follow-up appointments and motivated to follow the dietary program.
  5. Sufficient control over their food intake to adhere to study diets.
  6. Willingness to regularly monitor blood pressure, glucose, dietary intake, and body weight over the 4-month trial

Exclusion Criteria:

  1. Any subject pregnant or nursing
  2. Comorbidity of developmental delay
  3. Active substance abuse with illicit drugs or alcohol
  4. In a current severe mood or psychotic state when entering the study that would prohibit compliance with study visits or dietary program.
  5. Anyone who has been hospitalized or taken clozapine over the past 3 months
  6. Inability to complete baseline measurements
  7. Severe renal or hepatic insufficiency

  8. Cardiovascular dysfunction, including diagnosis of:

    1. Congestive heart failure
    2. Angina
    3. Arrhythmias
    4. Cardiomyopathy
    5. Valvular heart disease
  9. Any other medical condition that may make either diet dangerous as determined by the study medical team (e.g. anorexia nervosa)
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Shebani Sethi Dalai, MD 650-721-4419 shebanis@stanford.edu
Contact: Kat Nameth, M.S. 650-721-2168 knameth@stanford.edu

Locations
Layout table for location information
United States, California
Stanford University Department of Psychiatry & Behavioral Sciences Recruiting
Stanford, California, United States, 94305
Contact: Kat Nameth Clinical Research Coordinator    650-721-2168    knameth@stanford.edu   
Sub-Investigator: Farnaz Hooshmand, MD         
Sub-Investigator: Laura Saslow, PhD         
Sponsors and Collaborators
Stanford University
Investigators
Layout table for investigator information
Principal Investigator: Shebani Sethi Dalai, MD Stanford University
Tracking Information
First Submitted Date  ICMJE April 30, 2019
First Posted Date  ICMJE May 2, 2019
Last Update Posted Date February 16, 2021
Actual Study Start Date  ICMJE February 13, 2019
Estimated Primary Completion Date December 2021   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: April 30, 2019)
  • Change in heart rate from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in blood pressure from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in weight from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in body fat mass from baseline [ Time Frame: Baseline, 16 weeks ]
  • Percent Change in Hemoglobin A1c from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in insulin resistance measure (HOMA-IR) from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in inflammatory marker (hsCRP) from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in lipid profile (triglycerides) from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in lipid profile (small dense LDL) from baseline [ Time Frame: Baseline, 16 weeks ]
  • Change in lipid profile (HDL) from baseline [ Time Frame: Baseline,16 weeks ]
Original Primary Outcome Measures  ICMJE Same as current
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: April 30, 2019)
  • Psychiatric Indices - Mood [ Time Frame: Baseline, 16 weeks ]
    Change in Mood Score (Clinical Mood Monitoring) from baseline
  • Psychiatric Indices- Clinical Global Impression [ Time Frame: Baseline, 16 weeks ]
    Change in Clinical Global Impression Scales (CGI) from baseline
  • Psychiatric Indices- Global Assessment of Functioning [ Time Frame: Baseline, 16 weeks ]
    Change in Global Assessment of Functioning (GAF) Scale from baseline
  • Psychiatric Indices- Quality of Life [ Time Frame: Baseline, 16 weeks ]
    Change in Manchester Quality of Life Scale (MANSA) from baseline
  • Psychiatric Indices- BPRS [ Time Frame: Baseline, 16 weeks ]
    Change in Brief Psychiatric Rating Scale (BPRS) from baseline
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Impact of a Ketogenic Diet on Metabolic and Psychiatric Health in Patients With Schizophrenia or Bipolar Illness
Official Title  ICMJE Impact of A Low-Carbohydrate, High-Fat, Ketogenic Diet on Obesity, Metabolic Abnormalities and Psychiatric Symptoms in Patients With Schizophrenia or Bipolar Illness: An Open Pilot Trial
Brief Summary

To initiate a low-carbohydrate, high-fat (LCHF) ketogenic dietary intervention among a small cohort of outpatients with either schizophrenia or bipolar illness and comorbid overweight/obesity currently taking psychotropic medications.

Adults with mental illness represent a high-risk, marginalized group in the current obesity epidemic. Among US adults with severe mental illness, obesity and overweight 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. In addition, many psychiatric medications, particularly antipsychotics and mood stabilizers, can contribute to metabolic side effects and weight gain. Low-carbohydrate high-fat (LCHF) diets have been shown to reduce cardiovascular risk in those with insulin resistance. The purpose of this study is to evaluate both the metabolic and psychiatric outcomes with an LCHF diet in this psychiatric population.
Detailed Description Not Provided
Study Type  ICMJE Interventional
Study Phase  ICMJE Not Applicable
Study Design  ICMJE Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Condition  ICMJE
  • Obesity
  • Ketogenic Dieting
  • Metabolic Syndrome
  • Bipolar Disorder
  • Schizophrenia
  • Weight Gain
  • Psychotropic Drug, Unspecified Causing Adverse Effects in Therapeutic Use
Intervention  ICMJE Other: LCHF, Ketogenic Diet
Low Carbohydrate, Moderate Protein, High Fat Ketogenic Dietary Intervention 16 weeks
Study Arms  ICMJE Experimental: Ketogenic Diet 16 Week Group
Intervention: Other: LCHF, Ketogenic Diet
Publications *
  • Sethi Dalai 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. Review.
  • Carmen M, Safer DL, Saslow LR, Kalayjian T, Mason AE, Westman EC, Sethi Dalai 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.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: April 30, 2019) 		20
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE December 2021
Estimated Primary Completion Date December 2021   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  1. Age 18-70 years old
  2. Meet DSM V criteria for schizophrenia or bipolar disorder, any subtype, for > 1 year and clinically stable (with no hospitalization for past 3 months)
  3. Currently taking 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)
  4. Willing to consent to all study procedures and attend follow-up appointments and motivated to follow the dietary program.
  5. Sufficient control over their food intake to adhere to study diets.
  6. Willingness to regularly monitor blood pressure, glucose, dietary intake, and body weight over the 4-month trial

Exclusion Criteria:

  1. Any subject pregnant or nursing
  2. Comorbidity of developmental delay
  3. Active substance abuse with illicit drugs or alcohol
  4. In a current severe mood or psychotic state when entering the study that would prohibit compliance with study visits or dietary program.
  5. Anyone who has been hospitalized or taken clozapine over the past 3 months
  6. Inability to complete baseline measurements
  7. Severe renal or hepatic insufficiency

  8. Cardiovascular dysfunction, including diagnosis of:

    1. Congestive heart failure
    2. Angina
    3. Arrhythmias
    4. Cardiomyopathy
    5. Valvular heart disease
  9. Any other medical condition that may make either diet dangerous as determined by the study medical team (e.g. anorexia nervosa)
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 18 Years to 70 Years   (Adult, Older Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Shebani Sethi Dalai, MD 650-721-4419 shebanis@stanford.edu
Contact: Kat Nameth, M.S. 650-721-2168 knameth@stanford.edu
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03935854
Other Study ID Numbers  ICMJE 48527
Has Data Monitoring Committee No
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Shebani Sethi Dalai, Stanford University
Study Sponsor  ICMJE Stanford University
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Shebani Sethi Dalai, MD Stanford University
PRS Account Stanford University
Verification Date February 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP

治疗医院

新药特效药

前沿医讯