Combined Cytidine and Creatine-containing Drug in the Treatment of the Bipolar Depression

A Double-Blind, Placebo-Controlled Trial of Combined Cytidine- and Creatine-containing Drug and Dietary Supplement in the Treatment of the Bipolar Depression

This research is aimed to investigate the efficacy and safety of the creatine and cytidine augmentation in treating bipolar depression and to evaluate changes in relevant brain biochemical metabolism using proton and phosphorous magnetic resonance spectroscopy.

Inclusion Criteria:

• Aged 19-65 years
• Bipolar disorder I or II (DSM-IV-TR) with current depressive episode
• Informed consent

Exclusion Criteria:

• Use of medication for bipolar depression or other psychotropic drugs
• Current Axis I mental disorders other than bipolar depression based on structured clinical interview
• Current borderline or antisocial personality disorder based on structured clinical interview
• Major medical or neurological illnesses (epilepsy, multiple sclerosis, brain tumor, cerebrovascular disease, etc)
• Hypersensitivity to divalproate or valpromide
• Diagnosis of porphyria
• Current or past liver diseases
• Severe dysfunction in liver or pancreas
• Use of mefloquine
• Alcohol or substance abuse/dependence
• Intelligence quotient of 80 or below
• Contraindications to magnetic resonance imaging
• Pregnancy or breastfeeding
• Allergy or intolerance to the study drugs