The research project has been cancelled before any participants were enrolled.

This proposed research is aimed to investigate the efficacy and safety of combined cytidine- and creatine-containing drug and dietary supplement in treating bipolar depression and to evaluate changes in relevant brain biochemical metabolism using magnetic resonance spectroscopy.

Inclusion Criteria:

• 19-65 year-old male or female
• Bipolar depression diagnosed by Structured Clinical Interview for DSM-IV (SCID-IV)
• Written informed consent

Exclusion Criteria:

• Present use of drugs for bipolar depression or any psychotropic medication
• Use of psychoactive medication that may affect brain imaging findings
• Diagnosis of any other axis I psychiatric disorder
• Presence of borderline personality disorder or antisocial personality disorder
• Presence of any major physical or neurological illness (e.g., epilepsy, multiple sclerosis, brain tumor, cerebrovascular disease, etc.)
• Hypersensitivity to divalproate, valpromide or diagnosis of porphyria
• Past or current liver disease, current severe liver or pancreas dysfunction
• Currently taking mefloquine
• Presence of alcohol or drug dependence, drug abuse
• Intelligence quotient below 80
• Contraindications to magnetic resonance imaging
• Women who are pregnant, breastfeeding, or planning pregnancy
• Allergy or intolerance to the study drugs