Functional and Neurochemical Brain Changes Bipolar Depression

Inclusion criteria

- Depressed bipolar patients (N=100; 15-20 patients/year):

• Patients will meet DSM-IV criteria for type I bipolar disorder, depressed, as determined by structured interview and best-estimate diagnostic procedures.138
• Patient has experienced a maximum of three documented affective episodes.
• Patient has been off medications for one week prior to study enrollment.
• Patient has a Hamilton Depression Rating Scale (HDRS) total score ≥20
• Patient is between the ages of 12 and 35 years.

Exclusion criteria

All subjects will be excluded from participation for the following reasons:

• Any chemical use disorder within 3 months.
• Any history of significant suicidality that would place the patient at risk to participate in this protocol.
• Current score ≥3 on item 3 of the HDRS-17 (Suicide Item)
• Any medical or neurological disorder that could influence fMRI results.
• A history of mental retardation or an estimated IQ total score <85.
• An MRI scan is contraindicated in the subject for any reason.
• The patient lives >100 miles from the University of Cincinnati or cannot attend follow-up visits.
• Meets DSM-IV criteria for a bipolar mixed episode