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Not yet recruitingNCT07570875Updated Sep 21, 2026

Evaluating the Impact of Ketogenic Therapy on Symptom Severity and Metabolic Side Effect Profile Among Individuals Living With Bipolar Disorder in A Rural Southern Catchment Area

An interventional study of Ketogenic foodstuffs and Standard of Care Oral antipsychotics in Bipolar Disorder, sponsored by University of Alabama at Birmingham. Not yet recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-21.

Sponsored by University of Alabama at Birmingham · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
100
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

It is the purpose of this pilot study to evaluate a high-fat/low-carbohydrate "ketogenic" diet-based intervention as an adjunctive strategy for impacting symptoms of bipolar disorder. The study is designed to evaluate this impact in the rural southern catchment area around Montgomery, Alabama.

While existing access and cost barriers can prevent effective treatment of bipolar disorder in the rural south, using food as medicine represents a possible alternative/adjunctive to traditional high-cost/low-access medications. Specifically, this study will evaluate the impact of combining a ketogenic diet with existing treatment options, under the conditions of the rural catchment area, to determine the impact and efficacy of this intervention at patient and systems levels.

If effective, the interventions examined in this pilot study may increase the efficacy, availability and access to care experienced by individuals living with bipolarity in the rural Deep South.

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Conditions studied

  • Bipolar Disorder

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Keywords

  • ketogenic
  • long-acting injectable
  • rural
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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age >18
  • Verified Bipolar Diagnosis per NETSCID

Exclusion criteria

Exclusion Criteria:

  • Acute psychiatric instability (manic episode, active suicidality requiring hospitalization)
  • Anorexia
  • Pregnancy
  • Severe renal insufficiency
  • Hepatic insufficiency
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Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Active comparator
    Oral bipolar medication only

    Participants in this arm will receive oral medication treatment as usual for bipolar disorder. These medications may include second generation antipsychotic mood stabilizing medications aripiprazole, risperidone, quetiapine, and olanzapine.

    Other: Standard of Care Oral antipsychotics

  • Active comparator
    Long-acting injectable medication only

    Participants in this arm will receive long-acting injectable medication as treatment for bipolar disorder. This medication may include aripiprazole monohydrate.

    Other: Standard of care long acting injectable medication for bipolar disorder

  • Experimental
    Oral medication + ketogenic diet

    Participants in this arm will receive oral medication for bipolar disorder, plus foodstuffs necessary to support ketogenic diet. Oral medications may include second generation antipsychotic mood stabilizing medications aripiprazole, risperidone, quetiapine, and olanzapine.

    Dietary Supplement: Ketogenic foodstuffs · Other: Standard of Care Oral antipsychotics

  • Experimental
    Long-acting injectable medication + ketogenic diet

    Participants in this arm will receive long-acting injectable medication for bipolar disorder, plus foodstuffs necessary to support ketogenic diet. The medication used may include aripiprazole monohydrate.

    Dietary Supplement: Ketogenic foodstuffs · Other: Standard of care long acting injectable medication for bipolar disorder

Interventions

  • Dietary supplementKetogenic foodstuffs

    Weekly food box, selected from rotating menu of three options, as designed by study dietician to include ketogenic foodstuffs.

  • OtherStandard of Care Oral antipsychotics

    Oral mood stabilizing antipsychotics for the treatment of bipolar disorder. These medications may include second generation antipsychotic mood stabilizing medications aripiprazole, risperidone, quetiapine, and olanzapine.

  • OtherStandard of care long acting injectable medication for bipolar disorder

    Long-acting injectable antipsychotic mood stabilizing medication for bipolar disorder. The medication used may include aripiprazole monohydrate.

05

What researchers measure

Primary outcomes

  1. Impact on Symptom Severity as measured by Young Mania Ratings Scale

    The Young Mania Rating Scale (YMRS) is a clinical assessment tool specifically designed to evaluate manic symptoms and their severity. The YMRS comprises 11 items. Each item is rated on a scale that varies in range, typically from 0 to 4 or 0 to 8, allowing for a nuanced measurement of symptoms. The total score can range from 0 to 60, with higher scores indicating more severe manic symptoms.

    Time frame: T0 (time of intake); T0+1 week; T0+2 weeks; T0+3 weeks; T0+4 weeks; T0+6 weeks; T0+8 weeks; T0+10 weeks; T0+12 weeks; T0+16 weeks; T0+20 weeks; T0+24 weeks

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Study locations

1 site
  • Baptist Medical Center South
    Montgomery, Alabama 36116-2496, United States
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References and documents

Publications

  • Yildiz A, Siafis S, Mavridis D, Vieta E, Leucht S. Comparative efficacy and tolerability of pharmacological interventions for acute bipolar depression in adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2023 Sep;10(9):693-705. doi: 10.1016/S2215-0366(23)00199-2. PubMed 37595997 ↗
  • Sethi S, Wakeham D, Ketter T, Hooshmand F, Bjornstad J, Richards B, Westman E, Krauss RM, Saslow L. Ketogenic Diet Intervention on Metabolic and Psychiatric Health in Bipolar and Schizophrenia: A Pilot Trial. Psychiatry Res. 2024 May;335:115866. doi: 10.1016/j.psychres.2024.115866. Epub 2024 Mar 20. PubMed 38547601 ↗
  • Kishi T, Ikuta T, Matsuda Y, Sakuma K, Okuya M, Nomura I, Hatano M, Iwata N. Pharmacological treatment for bipolar mania: a systematic review and network meta-analysis of double-blind randomized controlled trials. Mol Psychiatry. 2022 Feb;27(2):1136-1144. doi: 10.1038/s41380-021-01334-4. Epub 2021 Oct 12. PubMed 34642461 ↗

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT07570875
Lead sponsor
University of Alabama at Birmingham
Collaborators
Baszucki Family Foundation, Baptist Health System Montgomery
Responsible party
Will Rutland (Regional Chair of Psychiatry - Montgomery Campus, University of Alabama at Birmingham) — Principal investigator
First posted
May 6, 2026
Start date
Oct 2026 (estimated)
Primary completion
Apr 2027 (estimated)
Completion
Oct 2027 (estimated)
Last update
Sep 21, 2026

Study contacts

Will Rutland, MD
Contact
wrutland@uab.edu
334-747-7550
Will Rutland, MD
principal investigator · UAB Heersink School of Medicine - Montgomery Psychiatry

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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