AzTrials
AzTrials

Bipolar DisorderPhase 4MOBILITYNCT02515773

Metformin for Overweight & OBese ChILdren and Adolescents With BDS Treated With SGAs

A Phase 4 study testing Metformin and healthy lifestyle intervention (LIFE) in people with Bipolar Disorder, run by Melissa Delbello at 29 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

A prospective, large, pragmatic, randomized trial to study the impact of METFORMIN and healthy lifestyle intervention (LIFE) vs. LIFE alone on patient-centered outcomes of body weight, SGA-adherence and satisfaction, psychiatric symptom burden (e.g. mood/anxiety), and Quality of Life. Read more about this study

Who is it for?
Ages 8 to 19 years
Conditions the study is for
Bipolar Disorder
What is being tested?
Metformin and healthy lifestyle intervention (LIFE)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,565 participants
Where
29 sitesUnited States
Study dates
Dec 2015to Jun 2023
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 8 to 19 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Inpatient or outpatient age 8-19 years inclusive; participants must live with a parent, guardian, or caregiver;
  • Fluent in English;
  • Diagnosed or told by a clinician that they have any of the following bipolar spectrum disorders (BSD): bipolar I, bipolar II, unspecified bipolar and related disorders, Disruptive Mood Dysregulation Disorder (DMDD), cyclothymic disorder, other specified bipolar and related disorders, as well as mood disorder not otherwise specified (if diagnosed in the past as per DSM-IV);
  • Body mass index >85%ile for age and sex by standard growth charts;
  • Received a new or ongoing prescription for at least one SGA (i.e., olanzapine, clozapine, risperidone, quetiapine, aripiprazole, ziprasidone, iloperidone, lurasidone, paliperidone, brexpiprazole or cariprazine) that is not prescribed as a PRN medication;

Who cannot join

  • Patients will be excluded if they have had exposure to a total daily dose of MET 1000 mg bid for at least 2 weeks in the past 3 months;
  • Patients will be excluded if they could not tolerate MET during the recommended titration schedule outlined in the protocol;
  • Major neurological or medical illnesses that affect weight gain (e.g., unstable thyroid disease) or require a systemic medication that might impact weight or glucose regulation (e.g., diabetes mellitus [insulin], chronic renal failure [steroids]);
  • Fasting glucose ≥ 126 mg/dL on 2 occasions during screening indicating need for prompt treatment;
  • If lab results are available in the last 6 months, then a serum creatinine ≥1.3 mg/dL on 2 occasions during screening and/or follow-up, indicating potential impairment of renal functioning;
  • Pregnant or breast feeding;
  • Children and caregivers who are unable to complete assessments for any reason;

Trial locations and contacts

29 sites in 1 country.

29 sites in 1 country

United States29 sites
  • South Oaks

    Amityville, New York, 11701

  • Seton Family of Hospitals

    Austin, Texas, 78712

  • SUNY Downstate/ Kings County Hospital

    Brooklyn, New York, 11203

  • Maimonides

    Brooklyn, New York, 11219

  • NYCCC

    Brooklyn, New York, 11233

  • Lighthouse Youth Services

    Cincinnati, Ohio, 45206

  • Central Clinic

    Cincinnati, Ohio, 45219

  • Children's Home

    Cincinnati, Ohio, 45227

  • Cincinnati Children's Hospital Medical Center

    Cincinnati, Ohio, 45229

  • Resident Mood Medication Clinic

    Cincinnati, Ohio, 45229

  • St. Aloysius

    Cincinnati, Ohio, 45237

  • Talbert House

    Cincinnati, Ohio, 45238

  • St. Joseph's Orphanage

    Cincinnati, Ohio, 45239

  • Child Focus

    Cincinnati, Ohio, 45244

  • NECCO

    Cincinnati, Ohio, 45246

  • University Hospital Medical Center Cleveland

    Cleveland, Ohio, 44106

  • Nationwide Children's Hospital Columbus

    Columbus, Ohio, 43205

  • Ohio State University

    Columbus, Ohio, 43210

  • The Children's Home of Northern Kentucky

    Covington, Kentucky, 41011

  • South Community

    Dayton, Ohio

  • Northwell Zucker Long Island Jewish Hospital

    Glen Oaks, New York, 11004

  • Butler Behavioral Health Services

    Hamilton, Ohio, 45011

  • Jersey Shore Medical Center

    Neptune City, New Jersey, 07753

  • Mount Sinai

    New York, New York, 10029

  • LIJ Zucker Hillside Hospital

    New York, New York, 11004

  • Child Center of New York,

    Queens, New York, 11373

  • NorthShore Child and Family Guidance

    Roslyn Heights, New York, 11577

  • StonyBrook

    Stony Brook, New York, 11794

  • TCN Family Solutions

    Xenia, Ohio, 45385

Other trials in United States

About this study

Official title: MOBILITY- Metformin for Overweight & OBese ChILdren and Adolescents With BIpolar Spectrum Disorders Treated With Second-Generation AntipsYchotics

A prospective, large, pragmatic, randomized trial to study the impact of METFORMIN and healthy lifestyle intervention (LIFE) vs. LIFE alone on patient-centered outcomes of body weight, SGA-adherence and satisfaction, psychiatric symptom burden (e.g. mood/anxiety), and Quality of Life.

Read the detailed description

The investigators propose to recruit 1800 overweight/obese youth with Bipolar Spectrum Disorder (BSD) who are prescribed second generation anti psychotics (SGAs) from at least 24 public and private mental health practices in the Greater Cincinnati and New York City regions, (approximately 900 each from ~12 Cincinnati region and ~12 Long Island/New York mental health treatment sites) to participate in the proposed patient-centered large pragmatic trial examining the effectiveness of MET and LIFE vs. LIFE alone. Patients will be eligible if they are ages 8-17 years old, inclusive, overweight or obese (BMI > 85%), continuing or starting treatment with at least one SGA (i.e., olanzapine, clozapine, risperidone, quetiapine, aripiprazole, ziprasidone, iloperidone, lurasidone, paliperidone, or asenapine) and have a clinical diagnosis of BSD (bipolar I or II disorder, cyclothymia, or bipolar or mood disorder not otherwise specified [or by Diagnostic and Statistical Manual of Mental Disorders V (DSM-5), other specified bipolar or mood disorder). The enrollment rate will be 2-3 patients/month/site for a recruitment time of 30 months.

Being tested
Metformin, healthy lifestyle intervention (LIFE)
Medical subject headings
Bipolar Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MetforminDrug

    Also called GLUCOPHAGE

    Metformin - to achieves maximum insulin-sensitizing effects

  • healthy lifestyle intervention (LIFE)Behavioural

    Also called LIFE

    Healthy Life style intervention

Study groups in NCT02515773
Study groupRoleWhat they receive
MET and LIFEExperimentalParticipants randomized to this group will receive both Metformin and lifestyle intervention.Participants randomized to treatment with MET will start at a dose of 500 mg orally at night and slowly titrated in 2-week intervals to ensure that each patient achieves maximum insulin-sensitizing effects of the drug while minimizing the chance of side effects. Investigators will also recommend that MET be taken with food to minimize side effects. If a participant's BMI percentile <5% (=underweight) his/her treatment with MET will be discontinued. Although the risk of low vitamin B12 while taking MET is associated with age > 50 years and having type II diabetes, Investigator will monitor B12 levels and a CBC throughout study participation.
Receives: Drug: Metformin; Behavioral: healthy lifestyle intervention (LIFE)
Healthy lifestyle intervention (LIFE)ExperimentalParticipants randomized to this group will receive just lifestyle intervention alone.This healthy lifestyle intervention (LIFE) consists of counseling participants and families regarding a healthy eating plan, physical activity and sedentary activities. Prior to study initiation, clinical site staff will participate in a live (or taped) training session from a dietician to lean to administer LIFE. A trained site staff member (e.g. medical assistant or case manager) will meet with participants and their families for a 15-20 minute session at baseline that will focus on nutritional issues using the Traffic Light Plan (TLP).
Receives: Behavioral: healthy lifestyle intervention (LIFE)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in BMI Z-score From Baseline to Month 6 in ITT Sample

    Raw body mass index (BMI) is calculated as (weight(kg)/ height(m)2). This raw BMI value is converted to a normalized BMI z-score, adjusted for age and sex using US Centers for Disease Control and Prevention growth charts. A z-score equal to 0 indicates the population mean and larger z-scores are heavier weights and worse outcomes.

    Measured: Baseline to Month 6

  2. Change in BMI Z-score From Baseline to Month 24 in ITT Sample

    Raw body mass index (BMI) is calculated as (weight(kg)/ height(m)2). This raw BMI value is converted to a normalized BMI z-score, adjusted for age and sex using US Centers for Disease Control and Prevention growth charts. A z-score equal to 0 indicates the population mean and larger z-scores are heavier weights and worse outcomes.

    Measured: Baseline to Month 24

  3. Change in BMI Z-score From Baseline to Month 6 in Per Protocol Sample

    Raw body mass index (BMI) is calculated as (weight(kg)/ height(m)2). This raw BMI value is converted to a normalized BMI z-score, adjusted for age and sex using US Centers for Disease Control and Prevention growth charts. A z-score equal to 0 indicates the population mean and larger z-scores are heavier weights and worse outcomes.

    Measured: Baseline to Month 6

  4. Change in BMI Z-score From Baseline to Month 24 in Per Protocol Sample

    Raw body mass index (BMI) is calculated as (weight(kg)/ height(m)2). This raw BMI value is converted to a normalized BMI z-score, adjusted for age and sex using US Centers for Disease Control and Prevention growth charts. A z-score equal to 0 indicates the population mean and larger z-scores are heavier weights and worse outcomes.

    Measured: Baseline to Month 24

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Aug 2015 (estimated)
  2. Study startDec 2015
  3. Primary completionDec 2022
  4. Study completionJun 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,565 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02515773
Sponsor's protocol ID
DelBello PCORI
Acronym
MOBILITY
Status last verified
Dec 2024
First submitted
31 Jul 2015
Last updated
14 Jan 2025
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • DelBello MP, Welge JA, Klein CC, Blom TJ, Fornari V, Higdon C, Sorter MT, Kurtz B, Starr C, Smith A, Huang B, Chen C, Modi AC, Crimmins N, Correll CU; MOBILITY Consortium. Metformin for overweight and obese children and adolescents with bipolar spectrum and related mood disorders treated with second-generation antipsychotics: a randomised, pragmatic trial. Lancet Psychiatry. 2025 Dec;12(12):893-905. doi: 10.1016/S2215-0366(25)00273-1.

    PubMed 41233082
  • Higdon C, Welge JA, Crimmins NA, Klein CC, Fornari VM, Sorter MT, Blom TJ, Kurtz BP, Correll CU, DelBello MP. Metabolic syndrome in youth with bipolar spectrum disorders treated with second-generation antipsychotics: baseline results from the community-based pragmatic MOBILITY Trial. Eur Child Adolesc Psychiatry. 2025 Sep;34(9):2917-2929. doi: 10.1007/s00787-025-02680-2. Epub 2025 Apr 11.

    PubMed 40214755
  • Welge JA, Correll CU, Sorter MT, Fornari VM, Blom TJ, Carle AC, Huang B, Klein CC, DelBello MP. Metformin for Overweight and Obese Children With Bipolar Spectrum Disorders Treated With Second-Generation Antipsychotics (MOBILITY): Protocol and Methodological Considerations for a Large Pragmatic Randomized Clinical Trial. JAACAP Open. 2023 Mar 13;1(1):60-73. doi: 10.1016/j.jaacop.2023.03.004. eCollection 2023 Jun.

    PubMed 39554834

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Metformin and healthy lifestyle intervention (LIFE) in people with Bipolar Disorder, run by Melissa Delbello at 29 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 29 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Jan 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in BMI Z-score From Baseline to Month 6 in ITT Sample (time frame: Baseline to Month 6). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02515773, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jan 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in