Efficacy of Metformin as an Adjunct to Standard Antidepressant Therapy in Treating Depression Among Obese Patients

NCT ID: NCT06707012

Last Updated: 2025-09-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-01

Study Completion Date

2026-12-31

Brief Summary

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To evaluate the efficacy of metformin as an adjunct therapy in improving depressive symptoms and metabolic markers in newly diagnosed obese depressed patients on standard antidepressant therapy.

investigator will compare between Two groups

1\. metformin group 2 placebo group Primary outcome measure will be the improvement in depressive symptoms, indicating by a reduction in Hamilton Depression Rating Scale (HAM-D) scores. Secondary outcome measures will include the assessment of oxidative stress markers, specifically by measuring the increase in enzymatic activity of superoxide dismutase, catalase, and glutathione peroxidase Investigators hypothesize that the addition of metformin to standard antidepressant treatment will result in a significant reduction in symptoms of depression among newly diagnosed obese individuals.

Detailed Description

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This is a comparative clinical study with randomized groups. Participants will be allocated to either the metformin group or the placebo group in conjunction with standard antidepressant therapy. Randomization will be achieved using computer generated numbers in 1:1 ratio.

Metformin Group: Starting dose of 500 mg metformin once daily, titrated up to 2000 mg/day based on tolerance along with standard treatment of depression according to Maudsley guidelines.

Placebo Group: Identical placebo tablets, following the same titration schedule as the metformin group along with standard treatment of depression.

Study will take place at psychiatric Out Patient Department of Fazaia Ruth Pfau Medical College and Hospital Karachi Pakistan

Investigators will recruit participants from the psychiatric outpatient department of PAF Hospital diagnosed with depression according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition for at least 2 weeks and having obesity. depression is assessed with help of Hamilton Depression Scale (HAM-D). Participants whose score is above 8 and will meet the inclusion criteria will be added in study.

Informed consent:

Participants who meets the criteria will be asked for written informed consent form and explain in detail about the study

Base Line Data Collection After taking informed consent, detailed history, physical examination, HbA1c and serum creatinine will be measured. Participants whose HbA1c results is below 5.7% and creatinine clearance is above 30% will be selected in the study. Investigators will assess HbA1c, serum creatinine levels at every 12 weeks' interval. Serum levels of antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase) will measured in participants by using biochemical assays at baseline and at the end of the study.

Follow up visits Participants will be followed up six times throughout the study duration. 1st follow up visit will occur at 4th week to evaluate the response to treatment by using Hamilton depression rating scale for depression, as according to Maudsley guidelines initial response to treatment should be assessed within 4 weeks. Next follow ups will take place at every 6th week till 36 weeks to assess improvement in depression and changes in BMI.

Conditions

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Depression

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Study Design This is a comparative clinical study with randomized groups. Participants will be allocated to either the metformin group or the placebo group in conjunction with standard antidepressant therapy. Randomization will be achieved using computer generated numbers in 1:1 ratio.

Metformin Group: Starting dose of 500 mg metformin once daily, titrated up to 2000 mg/day based on tolerance along with standard treatment of depression according to Maudsley guidelines.

Placebo Group: Identical placebo tablets, following the same titration schedule as the metformin group along with standard treatment of depression

Setting:

At psychiatric Out Patient Department of Fazaia Ruth Pfau Medical College and Hospital Karachi Pakistan

Study Duration:

18 months
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators
This will be double blind study in which participant and investigator who prescribe the drug will be blind

Study Groups

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Experimental

We will prescribe metformin with starting dose of 500 mg metformin once daily, titrated up to 2000 mg/day based on tolerance along with standard treatment of depression according to Maudsley guidelines.

Group Type EXPERIMENTAL

Metformin Hydrochloride

Intervention Type DRUG

Participants will be divided in 2 groups

1 group will receive metformin and 2nd group will receive placebo

placebo group

Identical placebo tablets, following the same titration schedule as the metformin group along with standard treatment of depression

Group Type PLACEBO_COMPARATOR

Metformin Hydrochloride

Intervention Type DRUG

Participants will be divided in 2 groups

1 group will receive metformin and 2nd group will receive placebo

Interventions

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Metformin Hydrochloride

Participants will be divided in 2 groups

1 group will receive metformin and 2nd group will receive placebo

Intervention Type DRUG

Other Intervention Names

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GLUCOPHAGE

Eligibility Criteria

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Inclusion Criteria

* • Age \>18 to \<45 years

* Gender: Both genders (Male and Female)
* BMI \>25
* Diagnosis: Newly diagnose cases of depression (mild to severe)
* HBA1C: Less than 5.7% (non-diabetic range)

Exclusion Criteria

* Existing diabetes

* Acute illnesses like acute kidney injury, recent history of myocardial infarction, acute liver injury
* Intellectual disabilities or inability to understand due to any reason
* Presence of Psychiatric disorders other than depression
* Chronic kidney disease (eGFR \< 45 mL/min/1.73 m²).
* Use of any psychotropic medication within the past 6 months.
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fazaia Ruth Pfau Medical College

OTHER

Sponsor Role lead

Responsible Party

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Sadia khan

Dr. Sadia Khan MBBS resident FCPS Pharmacology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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sadia khan, MBBS

Role: PRINCIPAL_INVESTIGATOR

Fazaia Ruth Pfau Medical College

Locations

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Fazaia Rurh Pfau Medical College

Karachi, Sindh, Pakistan

Site Status RECRUITING

Fazaia Ruth Pfau Medical College

Karachi, Sindh, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Sadia khan, MBBS

Role: CONTACT

0331359046 ext. 314

Asghar Mehdi, MBBS,PHD

Role: CONTACT

03008228284 ext. 316

Facility Contacts

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Masood Ahmed, MBBS,PHD

Role: primary

03002922361

Asgher Mehdi, MBBS

Role: backup

03008228284

sadia khan, MBBS

Role: primary

0331395046

Asghar Mehdi, MBBS,PHD

Role: backup

03008228284

References

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Guo M, Mi J, Jiang QM, Xu JM, Tang YY, Tian G, Wang B. Metformin may produce antidepressant effects through improvement of cognitive function among depressed patients with diabetes mellitus. Clin Exp Pharmacol Physiol. 2014 Sep;41(9):650-6. doi: 10.1111/1440-1681.12265.

Reference Type BACKGROUND
PMID: 24862430 (View on PubMed)

Farooq S, Khan T, Zaheer S, Shafique K. Prevalence of anxiety and depressive symptoms and their association with multimorbidity and demographic factors: a community-based, cross-sectional survey in Karachi, Pakistan. BMJ Open. 2019 Nov 19;9(11):e029315. doi: 10.1136/bmjopen-2019-029315.

Reference Type BACKGROUND
PMID: 31748286 (View on PubMed)

Heiskanen TH, Niskanen LK, Hintikka JJ, Koivumaa-Honkanen HT, Honkalampi KM, Haatainen KM, Viinamaki HT. Metabolic syndrome and depression: a cross-sectional analysis. J Clin Psychiatry. 2006 Sep;67(9):1422-7. doi: 10.4088/jcp.v67n0913.

Reference Type BACKGROUND
PMID: 17017829 (View on PubMed)

Lang UE, Beglinger C, Schweinfurth N, Walter M, Borgwardt S. Nutritional aspects of depression. Cell Physiol Biochem. 2015;37(3):1029-43. doi: 10.1159/000430229. Epub 2015 Sep 25.

Reference Type BACKGROUND
PMID: 26402520 (View on PubMed)

Luppino FS, de Wit LM, Bouvy PF, Stijnen T, Cuijpers P, Penninx BW, Zitman FG. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010 Mar;67(3):220-9. doi: 10.1001/archgenpsychiatry.2010.2.

Reference Type BACKGROUND
PMID: 20194822 (View on PubMed)

Lee A, Morley JE. Metformin decreases food consumption and induces weight loss in subjects with obesity with type II non-insulin-dependent diabetes. Obes Res. 1998 Jan;6(1):47-53. doi: 10.1002/j.1550-8528.1998.tb00314.x.

Reference Type BACKGROUND
PMID: 9526970 (View on PubMed)

Seifarth C, Schehler B, Schneider HJ. Effectiveness of metformin on weight loss in non-diabetic individuals with obesity. Exp Clin Endocrinol Diabetes. 2013 Jan;121(1):27-31. doi: 10.1055/s-0032-1327734. Epub 2012 Nov 12.

Reference Type BACKGROUND
PMID: 23147210 (View on PubMed)

AlHussain F, AlRuthia Y, Al-Mandeel H, Bellahwal A, Alharbi F, Almogbel Y, Awwad O, Dala'een R, Alharbi FA. Metformin Improves the Depression Symptoms of Women with Polycystic Ovary Syndrome in a Lifestyle Modification Program. Patient Prefer Adherence. 2020 Apr 15;14:737-746. doi: 10.2147/PPA.S244273. eCollection 2020.

Reference Type BACKGROUND
PMID: 32346286 (View on PubMed)

Calkin CV, Chengappa KNR, Cairns K, Cookey J, Gannon J, Alda M, O'Donovan C, Reardon C, Sanches M, Ruzickova M. Treating Insulin Resistance With Metformin as a Strategy to Improve Clinical Outcomes in Treatment-Resistant Bipolar Depression (the TRIO-BD Study): A Randomized, Quadruple-Masked, Placebo-Controlled Clinical Trial. J Clin Psychiatry. 2022 Feb 1;83(2):21m14022. doi: 10.4088/JCP.21m14022.

Reference Type BACKGROUND
PMID: 35120288 (View on PubMed)

Jitca G, Gall Z, Jitca CM, But MG, Majai E. Drug Repurposing of Metformin for the Treatment of Haloperidol-Related Behavior Disorders and Oxidative Stress: A Preliminary Study. Pharmaceutics. 2024 Mar 15;16(3):403. doi: 10.3390/pharmaceutics16030403.

Reference Type BACKGROUND
PMID: 38543297 (View on PubMed)

Other Identifiers

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FMC, University

Identifier Type: OTHER

Identifier Source: secondary_id

frpmc.edu.pk@sadiakhan12345678

Identifier Type: -

Identifier Source: org_study_id

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