Riluzole in the Treatment of Bipolar Depression

Riluzole in the Treatment of Bipolar Depression: A Study of the Association Between Clinical Response and Change in Brain Glutamate Levels as Measured by Proton Magnetic Resonance Spectroscopy

Bipolar disorder is a common and often chronic and debilitating mental illness. The depressive phase of bipolar disorder contributes the largest portion of the disorder, and treatment resistant bipolar depression represents a significant public health problem. Recent research has suggested that bipolar depression is associated with elevated brain glutamate activity. We hypothesize that riluzole, a drug approved for ALS which inhibits glutamate activity, will lead to clinical improvement in patients with bipolar depression.

We hypothesize that riluzole will lead to significant reduction in depressive symptoms as measured by the Hamilton Depression Rating Scale (HAM-D). Additionally, improvement in depressive symptoms will be associated with reduced glutamate levels in the anterior cingulate cortex, but not parieto-occipital cortex, both at day two and day 42.

Inclusion Criteria:

• Male or female age 18-65
• Meets DSM-IV criteria for Bipolar Disorder and is currently depressed
• Current score of >/= 18 on the Hamilton Depression Scale

Exclusion Criteria:

• Active psychotic/manic symptoms
• Lifetime history of schizophrenia or obsessive compulsive disorder
• Clinically significant medical disease
• Women who are pregnant or lactating and women who are not using a medically accepted method of contraception.