N/A N=53 Randomized Double-blind Basic Science

Ketogenic Diet (KD) in Alcoholism

Alcoholism

Bottom Line

View on ClinicalTrials.gov: NCT03255031 ↗

Enrolled (actual)

Serious AEs

0.0%

Results posted

Jul 2024

Primary outcome: Primary: Withdrawal Symptoms Measured Using the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) — 4.16; 6.57 score on a scale — p=0.067

Study Design & Population

Study type: Interventional
Phase: N/A
Interventions: Ketogenic Diet (KD) (Other); Standard American (SA) Meals and Shakes (Other)
Age: Adult, Older Adult · 18+ yrs
Sex: All
Sponsor: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Primary completion: May 2020

Outcome Measures

Outcome	Result	p-value
PRIMARY Withdrawal Symptoms Measured Using the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)	4.16; 6.57	0.067
PRIMARY Quantification of Medications for Control of Withdrawal Symptoms	34.21; 156.43	0.004 sig
PRIMARY Brain Functions During Resting State: Sensorimotor Brain Network	0.5314; 0.4816; 0.5067; 0.5028; 0.4932; 0.4849	—
PRIMARY Brain Functions During Resting State: Association Brain Network	0.3647; 0.3125; 0.3624; 0.3346; 0.3563; 0.3206	—
PRIMARY Neurobiological Craving Signature (NCS) for Alcohol > Food Pictorial Cues	-2.13; .55; -2.38; -.67; -1.37; -.099	—
PRIMARY Brain Concentrations of Glutamate/Creatine	1.1980558; 1.1966429; 1.34895; 1.20654; 1.31244; 1.18600	—
PRIMARY Brain Volume Measured With Brain MRI	1482.111; 1462.667; 1481.0; 1463.75	—
SECONDARY Effect of Ketogenic Diet on Mood	18.22; 21.71; 6.39; 7.29; 6.26; 6.36	—
SECONDARY Effect of Ketogenic Diet on Sleep	5.6451754385263; 6.0624149660000; 5.7086466163684; 6.1456632652857; 5.6344611528421; 6.5103741495714	—
SECONDARY Effect of Ketogenic Diet on Alcohol Craving	22.00; 21.07; 17.53; 20.36; 15.88; 18.36	—

Summary

Background: A ketogenic diet (KD) is high in fat and low in carbohydrates. Research has shown that a KD can lessen tremor in animals withdrawing from alcohol. KD can also help people who have difficulties with thinking, sleep, and mood. Researchers want to see if KD can lessen symptoms of alcohol withdrawal in people with alcohol use disorder. Objective: To test the effects of a ketogenic diet on alcohol withdrawal symptoms. Eligibility: Adults 18 years or older who are moderate or severe alcohol drinkers and are seeking treatment for alcohol use. They must be in the NIAAA inpatient alcohol treatment program. Design: Participants will be screened under another protocol. They will have a medical and psychiatric history, physical exam, and blood and urine tests. Participants will have a breath test for alcohol. The study will be done in a 3-week stay in the clinic. Participants will get either a KD or Standard American diet. Participants will have breathalyzer, blood, and urine tests. Participants will have magnetic resonance imaging (MRI) scans. The scanner is a cylinder in a magnetic field. They will lie on a table that slides in and out of the cylinder. They will do tasks on a computer during the scan. Participants will have tests of thinking, memory, and attention. Participants will have their sleeping and waking measured. They will wear a device like a headband held in place with elastic straps. Several electrodes will be placed on the body. Participants will have heart tests. Participants will wear an activity monitor on the wrist. After the clinic stay, participants will be called by phone about 5 times over 3 months.

Eligibility Criteria

INCLUSION CRITERIA:

Patients with AUD

Age 18 years and older.
Ability to provide written informed consent as determined by clinical examination and verbal communication. Capacity to consent will be determined by those giving the informed consent.
DSM-IV diagnosis of alcohol dependence or alcohol abuse or DSM 5 diagnosis of moderate or severe AUD (established through history and clinical exam).
Participants seeking treatment for their AUD (self-report)
Minimum 5-year history of heavy drinking (SAMSHA s criteria for heavy drinking: for men 5 or more drinks/day on at least 5 different days per month; and for women 4 or more drinks/day on at least 5 different days per month [self-report]).
Alcohol specified as the preferred drug (self-report).
NIH employees with an AUD may participate in this study.

EXCLUSION CRITERIA

Unwilling or unable to refrain from use, within 24 hours of MRI and NPT procedures, psychoactive medications or medication that may affect study results (e.g., analgesics containing narcotics, antibiotics [must finish course at least 24 hours prior to a scheduled procedure], antidiarrheal preparations, anti-inflammatory drugs [systemic corticosteroids are exclusionary], antinauseants, cough/cold preparations) (self-report, medical history). The following medications are allowable for entry on this study: analgesics (non-narcotic); antacids; antiasthma agents that are not systemic corticosteroids; antifungal agents for topical use; antihistamines (non-sedating); H2-Blockers/proton pump inhibitors (PPI); laxatives. The use of antihyperlipidemics and/or diuretics are permitted as long as they have been taken for at least 1 month before procedure visits and dose has been stabilized.
Current DSM-IV or DSM 5 diagnosis of a major psychiatric disorder (other than alcohol and nicotine use disorders, or substance use disorders that are mild/moderate) that required hospitalization, or that required daily medications for over 4 weeks in the past year (i.e., antidepressants; anticholinergics; antipsychotics; anxiolytics; lithium; psychotropic drugs not otherwise specified (nos) including herbal products (no drugs with psychomotor effects or with anxiolytics, stimulant, antipsychotic, or sedative properties); sedatives/hypnotics). Chronic benzodiazepine use prior to alcohol detox will also be excluded. Note that nicotine and/or caffeine use will not exclude participation.
Chronic use of the following medications: analgesics containing narcotics; anorexics (sibutramine); antianginal agents; antiarrhythmics; antiasthma agents that are systemic corticosteroids; antibiotics; anticoagulants; anticonvulsants; antidiarrheal preparations; antifungal agents (systemic); antihistamines (sedating); antihypertensives (except angiotensin - converting

enzyme (ACE) inhibitors such as Lisinopril, or Angiotensin receptor blockers (ARB) such as Losartan); anti-inflammatory drugs (systemic); antineoplastics; antiobesity; antivirals (except for treatment of HSV with agents without CNS activity, e.g. acyclovir, ganciclovir, famciclovir, valacyclovir); cough/cold preparations (dextromethorphan preparations, pseudoephedrine); hormones (exceptions: thyroid hormone replacement, oral contraceptives, and estrogen replacement therapy); insulin; and muscle relaxants.

Major medical problems that can impact brain function or the use of a ketogenic diet (e.g., epilepsy, diabetes, liver disease, kidney disease, kidney stones (current and/or in the past), chronic metabolic acidosis or a cardiomyopathy) as determined by EKG, history and clinical exam.
Clinically significant laboratory findings that could affect brain function (e.g. HIV+).
Head trauma with loss of consciousness for more than 30 minutes (self-report, medical history).
Pregnant or breast-feeding: Females of childbearing potential, or with tubal ligation, or are post-menopausal and are age 60 or less will undergo a urine pregnancy test and it must be neg

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Data sourced from ClinicalTrials.gov (NCT03255031). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.