Schizoaffective Disorder Clinical Trial
Official title:
A Randomized Controlled Clinical Trial of Ketogenic and Nutritional Interventions for Brain Energy Metabolism and Psychiatric Symptoms in First Episode Bipolar Disorder.
This is a randomized, controlled clinical trial to assess the effects of the ketogenic diet in combination with treatment as usual on brain energy metabolism and psychiatric symptoms in individuals with first episode bipolar disorder and schizoaffective disorder.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | December 30, 2027 |
Est. primary completion date | September 30, 2027 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 45 Years |
Eligibility | Inclusion Criteria: - Between the ages of 18 and 45. - Ability to adhere to study diets. - Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) diagnosis of bipolar I disorder or schizoaffective disorder with onset of illness in the last 7 years. - Must have a stable psychiatric disorder with no change in psychiatric medications within the past 2 weeks of screening - Must not be expected to require addition of any new psychiatric medications during the 12-week duration of the study. Exclusion Criteria: - Unable to sign informed consent - Contraindication to magnetic resonance (MR) scan (including claustrophobia) - Unstable medical illness (including cardiovascular, hepatic, renal, respiratory, endocrine, neurological, or hematological disease) - Current DSM-5 substance use disorder - Currently pregnant, nursing, or of childbearing potential and not using a medically accepted means of contraception - Have a body weight of over 350 lbs or a body mass index (BMI) <20 - Score above 15 on the Young Mania Rating Scale (YMRS) - History of significant head injury - Current cancer diagnosis - Current diagnosis of type 1 or type 2 Diabetes Mellitus - History of gastric bypass surgery or any weight loss surgery - Concomitant treatment with Propofol - Familial hypercholesterolemia |
Country | Name | City | State |
---|---|---|---|
United States | McLean Hospital | Belmont | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Mclean Hospital | Baszucki Family Foundation |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in World Health Organization Disability Assessment Schedule (WHODAS) score | Change from baseline to week 12 in World Health Organization Disability Assessment Schedule (WHODAS) scale. Scores range from 0-144. A higher score indicates greater dysfunction and disability in major life domains. | 12 weeks | |
Other | Change in World Health Organization Quality of Life (WHOQOL) score | Change from baseline to week 12 in World Health Organization Quality of Life (WHOQOL) scale. Scores range from 1-130. A lower score indicates lower perceived quality of life. | 12 weeks | |
Other | Change in Extrapyramidal Symptom Rating Scale (ESRS) total score | Change from baseline to week 12 in Extrapyramidal Symptom Rating Scale (ESRS) total score. Scores range from 0-102; a higher score indicates more severe symptoms. | 12 weeks | |
Other | Change in Pittsburgh Sleep Quality Index (PSQI) total score | Change from baseline to week 12 in Pittsburgh Sleep Quality Index (PSQI) total score. Scores range from 0-21; a higher score indicates worse sleep quality. | 12 weeks | |
Primary | Change in brain redox nicotinamide adenine dinucleotide metabolites ratio (NAD+/NADH) | Change from baseline to week 12 in NAD+/NADH as measured by in vivo phosphorus magnetic resonance spectroscopy (31P-MRS). | 12 weeks | |
Primary | Change in brain creatine kinase forward reaction rate (kf) | Change from baseline to week 12 in creatine kinase forward reaction rate (kf) as measured by 31P magnetization transfer (MT) MRS. | 12 weeks | |
Primary | Change in insulin resistance | Change from baseline to week 12 of insulin resistance measured using the homeostatic model assessment of insulin resistance (HOMA-IR) using fasting blood glucose and insulin levels. | 12 weeks | |
Primary | Change in psychotic symptoms | Change from baseline to week 12 in Positive and Negative Syndrome Scale (PANSS) total score. Scores range from 30-210; a higher score indicates a higher level of psychotic symptoms. | 12 weeks | |
Primary | Change in depressive symptoms | Change from baseline to week 12 in Hamilton Rating Scale for Depression (HAM-D) total score. Scores range from 0-52; a higher score indicates a higher level of depression. | 12 weeks | |
Primary | Change in mania symptoms | Change from baseline to week 12 in Young Mania Rating Scale (YMRS) total score. Scores range from 0-60. A higher score indicates a more severe illness. | 12 weeks | |
Primary | Change in Clinical Global Impression (CGI) Scale | Change from baseline to week 12 in Clinical Global Impression (CGI) Scale. Scores range from 1-7; a higher score indicates higher severity of illness. | 12 weeks | |
Secondary | Change in body weight | Change from baseline to week 12 in participant body weight in kilograms, as measured using a standing scale. | 12 weeks | |
Secondary | Change in glycated hemoglobin (Hemoglobin A1c) level | Change from baseline to week 12 in fasting Hemoglobin A1c level. | 12 weeks | |
Secondary | Change in triglyceride levels | Change from baseline to week 12 in fasting triglyceride levels. | 12 weeks | |
Secondary | Change in low-density lipoprotein (LDL) levels | Change from baseline to week 12 in fasting LDL levels. | 12 weeks | |
Secondary | Change in high-density lipoprotein (HDL) levels | Change from baseline to week 12 in fasting HDL levels. | 12 weeks | |
Secondary | Change in high-sensitivity C-reactive protein (hs-CRP) levels | Change from baseline to week 12 in fasting hs-CRP levels. | 12 weeks | |
Secondary | Change in brain gamma-aminobutyric acid (GABA) concentration | Change from baseline to week 12 in GABA concentration measured by proton magnetic resonance spectroscopy. | 12 weeks | |
Secondary | Change in brain glutamate metabolite concentration | Change from baseline to week 12 in glutamate metabolite concentration measured by proton magnetic resonance spectroscopy. | 12 weeks | |
Secondary | Change in brain glutathione (GSH) | Change from baseline to week 12 in brain GSH measured by proton magnetic resonance spectroscopy. | 12 weeks | |
Secondary | Change in brain Phosphocreatine (PCr) | Changes from baseline to week 12 in PCr concentration as measured by in vivo 31P-MRS. | 12 weeks | |
Secondary | Change in brain pH | Change from baseline to week 12 in pH as measured by in vivo 31P MRS. | 12 weeks | |
Secondary | Change in brain inorganic phosphate concentration | Change from baseline to week 12 in inorganic phosphate (Pi) concentration as measured by in vivo 31P MRS. | 12 weeks | |
Secondary | Change in adverse events | Change from baseline to week 12 from baseline to week 12 in adverse events. | 12 weeks | |
Secondary | Change in anxiety symptoms | Change from baseline to week 12 from baseline to week 12 in Hamilton Anxiety Rating Scale (HAM-A) total score. Scores range from 0 - 56; a higher score indicates a higher level of anxiety. | 12 weeks | |
Secondary | Change in stress symptoms | Change from baseline to week 12 in Depression Anxiety Stress Scales (DASS-42) Stress Subscale score. Scores range from 0-42; a higher score indicates a higher level of stress. | 12 weeks | |
Secondary | Change in cognitive performance | Change from baseline to week 12 in Matrics Consensus Cognitive Battery (MCCB) Total Score. Scores range from 0.00% - 100.00%; a higher score indicates higher cognition. | 12 weeks | |
Secondary | Change in Global Functioning Scale (GFS) - Social and Role total score | Change from baseline to week 12 in Global Functioning Scale (GFS) - Social and Role total score. Scores range from 6-60; a lower score indicates worse social and role functioning. | 12 weeks |
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