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CTRI Number  CTRI/2024/09/073592 [Registered on: 09/09/2024] Trial Registered Prospectively
Last Modified On: 09/03/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group Trial 
Public Title of Study   To see the effects of metformin and dapagliflozin on weight gain in patients of bipolar-ii depression on olanzapine-fluoxetine combination 
Scientific Title of Study   A single blind randomized controlled trial to determine the efficacy and safety of metformin versus dapagliflozin on weight gain in patients of bipolar-ii depression treated with olanzapine-fluoxetine combination 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Sahil Singla 
Designation  Junior Resident 
Affiliation  Government Medical College, Patiala 
Address  Room no. 1 Department of Psychiatry Government Medical College Sangrur Road Patiala pin code 147001 Punjab India

Patiala
PUNJAB
147001
India 
Phone  7009350526  
Fax    
Email  sahilsingla3933@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Rajnish Raj 
Designation  Professor and Head 
Affiliation  Government Medical College, Patiala 
Address  Room no. 1 Department of Psychiatry Government Medical College Sangrur Road Patiala pin code 147001 Punjab India

Patiala
PUNJAB
147001
India 
Phone  9814913599  
Fax    
Email  Profheadpsy@yahoo.com  
 
Details of Contact Person
Public Query
 
Name  Rohit Garg 
Designation  Professor 
Affiliation  Government Medical College, Patiala 
Address  Room no. 10 Department of Psychiatry Government Medical College Sangrur Road Patiala pin code 147001 Punjab India

Patiala
PUNJAB
147001
India 
Phone  9888145477  
Fax    
Email  jrpsychiatry@gmail.com  
 
Source of Monetary or Material Support  
Department of Psychiatry Government Medical College Sangrur Road Patiala Punjab Pincode 147001 India 
 
Primary Sponsor  
Name  Government Medical College Patiala Punjab 
Address  Government Medical College Sangrur road Patiala Punjab Pincode 147001 India 
Type of Sponsor  Government medical college 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Sahil Singla  Rajindra Hospital  Room no. 2 Department of Psychiatry Government Medical College Sangrur road Patiala Punjab Pincode 147001 India
Patiala
PUNJAB 
7009350526

sahilsingla3933@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Ehical Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: F318||Other bipolar disorders,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Dapagliflozin  Group A consisting of 62 patients will be given dapagliflozin 10mg daily for 24 weeks. Patients will be assessed based on parameters like weight, body mass index, waist circumference, blood pressure, fasting lipid profile, fasting blood sugar, haemoglobin A1c, history of substance use, young mania rating scale score, bipolar depression rating scale score, clinical global impression – bipolar illness score, world health organization quality of life brief version score at baseline, 4 weeks, 12 weeks, 24 weeks. 
Intervention  Metformin  Group A consisting of 62 patients will be given Metformin 1000mg daily for 24 weeks. Patients will be assessed based on parameters like weight, body mass index, waist circumference, blood pressure, fasting lipid profile, fasting blood sugar, hemoglobin A1c, history of substance use, young mania rating scale score, bipolar depression rating scale score, clinical global impression – bipolar illness score, world health organization quality of life brief version score at baseline, 4 weeks, 12 weeks, 24 weeks. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  65.00 Year(s)
Gender  Both 
Details  1.Patients in the age group of 18 to 65 years.
2.Patients suffering from Bipolar-2 depression as per ICD-11 criteria.
3.Patients who will be medically stable.
4.Patients who will be accompanied by reliable informants.
5.Patients who develop Olanzapine-fluoxetine combination induced weight gain as established by Naranjo’s causality scale.
6.Patients and informants who give written informed consent and are willing participate in the study and take Tab Metformin and Tab Dapagliflozin as weight loss agents for Bipolar-2 depression.
 
 
ExclusionCriteria 
Details  1.Patients who have associated medical illness, which could affect the course of illness eg. Type 2 diabetes mellitus, hypertension, pulmonary/cardiovascular/renal/thyroid illnesses.
2.History of substance use disorder in the last six months.
3.Patient on other psychiatric medication known to increase weight.
A.Mood stabalizers: Lithium, Divalproex
B.Antipsychotics: Quetiapine, Clozapine, Risperidone.
4.Any other co-morbid psychiatric illness.
5.Patients requiring multiple psychotropics (except adjunct medication i.e. Benzodiazepines/ Propranolol).
6.Pregnant and Breastfeeding females.
7.Intellectual disability patients. Patients with history of epilepsy, or other organic disorder.
8.Contraindication to use of Metformin e.g. Hypersensitivity etc.
9.Contraindication to use of Dapagliflozin e.g. Hypersensitivity, Urinary tract infections (UTIs) etc.
10.Refusal to give written informed consent.
 
 
Method of Generating Random Sequence   Other 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
To estimate physical parameters including weight, body mass index, waist circumference and blood pressure in patients on antipsychotics and to compare lab investigations including fasting blood sugar, fasting lipid profile and glycated hemoglobin.  outcome will be assessed in four readings at baseline, 4 weeks, 12 weeks and 24 weeks 
 
Secondary Outcome  
Outcome  TimePoints 
To compare illness severity by bipolar depression rating scale score and clinical global impression – bipolar illness score, Quality of life on world health organization quality of life brief version score and adverse events on adverse drug reaction scale.
 
outcome will be assessed in four readings at baseline, 4 weeks, 12 weeks and 24 weeks 
 
Target Sample Size   Total Sample Size="124"
Sample Size from India="124" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   15/09/2024 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details
Modification(s)  
N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary
Modification(s)  

This hospital-based, interventional, comparative and prospective follow-up, single-blind randomized trial will be conducted in patients on antipsychotic use. The aim of this study will be to compare the efficacy and safety of two drugs i.e., metformin and dapagliflozin on weight gain in patients of Bipolar II depression treated with olanzapine–fluoxetine combination.Patients with depressive symptoms visiting outpatient department and/or admitted in inpatient department of psychiatry department will be screened for bipolar disorder using mood disorder questionnaire. Those patients who score >7 on mood disorder questionnaire will be assessed further using young mania rating scale to rule out mania. Patients who score ≤ 12 on young mania rating scale will be interviewed and diagnosed bipolar-II depression as per ICD-11 criteria. Severity of bipolar-II depression will be assessed using bipolar depression rating scale score and clinical global impression – bipolar illness score. Quality of life will be assessed using world health organization quality of life brief version score. These patients will then be screened according to the inclusion and exclusion criteria after recording the relevant physical parameters and lab investigations. Patients put on olanzapine-fluoxetine combination with or without adjunct medication for sleep/anxiety e.g. benzodiazepines, propranolol etc. and developing olanzapine-fluoxetine combination induced weight gain (defined as ≥ 5% weight gain within one month of initiating olanzapine-fluoxetine combination) will be considered eligible. To establish causality, Naranjo’s causality scale will be employed. A written informed consent will be taken. Eligible participants will undergo detailed  assessment  as per predesigned psychiatric proforma which will assess the socio-demographic profile, illness related details including seasonality, physical parameters including weight, body mass index, waist circumference, blood pressure and lab investigations including fasting lipid profile, fasting blood sugar, haemoglobin A1c etc. Patients will then be randomly allocated into two groups of 62 patients each. Group A will be given olanzapine-fluoxetine combination plus tablet metformin 1000 mg daily for a period for 24 weeks. Group B will be given olanzapine-fluoxetine combination plus tablet dapagliflozin 10 mg daily for a period for 24 weeks. Enrolled patients of two groups will be followed-up and the observations will be recorded at 0 week, 4 weeks, 12 weeks and 24 weeks after initiating weight lowering drugs. Data will be kept strictly confidential. Changes in the parameters of primary and secondary outcomes at the time of visit will be noted and will be subjected to appropriate statistical analysis.


 
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