Treatment Study of Bipolar Depression
Bipolar Disorder
About this trial
This is an interventional treatment trial for Bipolar Disorder focused on measuring Bipolar Disorder, Depression, Treatment-Resistant, ketamine, antidepressant, glutamate
Eligibility Criteria
Inclusion Criteria:
- Male or female patients, 21-70 years;
- Primary diagnosis of bipolar I or II disorder as assessed by the SCID-P and confirmed by a study psychiatrist;
- Current depressive episode ≥ 8 weeks duration;
- History of a failure to respond to at least three (3) adequate pharmacotherapy trials in the current depressive episode (see above for definition for adequate trials);
- Subjects must be on a stable dose of divalproex ER with serum levels greater than 55 mcg/ml prior to enrollment;
- Subjects must be free of psychotropic medication for at least 2 weeks (4 weeks for fluoxetine) prior to enrollment (with the exception of divalproex ER as above);
- Subjects must have scored ≥ 32 on the IDS-C30 at both Screening and Infusion Day #1 and #2;
Exclusion Criteria:
- Women who plan to become pregnant, are pregnant or are breast-feeding;
- Any unstable medical illness including hepatic, renal, gastroenterologic, respiratory, cardiovascular, endocrinologic, neurologic, immunologic, or hematologic disease;
- Clinically significant abnormal findings of laboratory parameters, physical examination, or ECG;
- Lifetime history of schizophrenia, schizoaffective disorder, OCD, mental retardation, pervasive developmental disorders, or Tourette's syndrome;
- Current presence of psychotic, mixed or manic symptoms;
- Lifetime history of antidepressant-induced switch to a manic episode;
- History of rapid cycling bipolar subtype;
- Drug or alcohol abuse within the preceding 3 months or dependence within the preceding 5 years;
- Lifetime exposure to ketamine or phencyclidine;
- Patients judged by study investigator to be at high risk for suicide.
Sites / Locations
- Mount Sinai School of Medicine
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Ketamine/Midazolam
Midazolam/Ketamine
Patients receive both treatment conditions (ketamine and midazolam) in a single arm, crossover design. Patients are randomized to ketamine-midazolam. Each treatment occurs as a single intravenous infusion on one treatment day. The two treatment conditions occur 2 weeks apart.
Patients receive both treatment conditions (ketamine and midazolam) in a single arm, crossover design. Patients are randomized to midazolam-ketamine. Each treatment occurs as a single intravenous infusion on one treatment day. The two treatment conditions occur 2 weeks apart.