Bipolar Disorder Clinical Trial
Official title:
A Combination of Cytidine and Omega-3 Fatty Acids in Bipolar Disorder: Are There Additive or Synergistic Mood Stabilizing Effects?
The goal of the proposed clinical trial is to assess the effect of oral cytidine and omega-3 fatty acids (O3FA) on bipolar disorder symptoms. This study is a 4-month, randomized, parallel-group, double-blind, placebo-controlled pilot study of a combination of cytidine and omega-3 fatty acids in 90 recently ill subjects with bipolar disorder. During the 16 week period of the study, subjects are assigned to one of three groups: 1) omega-3 fatty acids + cytidine supplementation, 2) omega-3 fatty acids supplementation alone, and 3) placebo supplementation.
Previous studies examining the effect of omega-3 fatty acids on bipolar depression have had
mixed results. Some studies have found that omega-3 fatty acids have a positive effect on
bipolar depression symptoms, while other studies have found no difference between placebo
and omega-3 fatty acid treatment.
The variable effects noted with omega-3 fatty acids may be due in part to a real effect with
limited potency. Larger effects might be achieved by combining agents with synergistic
effects.
Cytidine is necessary to form key intermediates in the biosynthesis of the phospholipids
phosphatidylcholine and phosphatidylethanolamine, which are major components of eukaryotic
cell membranes. Recent human studies by our group have shown that CDP-choline (a compound
composed of cytidine and choline) can modify brain phospholipid synthesis in healthy adults
and may have antidepressant effects (Babb et al., 1996; Babb et al., 2002; Carlezon et al.,
2002; Renshaw et al., 1999). The combination of omega-fatty acids and the related
pyrimidine, uridine, was associated with enhanced antidepressant-like activity in rats
(Carlezon et al., 2005). Thus, the combination of omega-3 fatty acid and cytidine, which is
interconverted with uridine in the body, may provide a safe and powerful way to treat
bipolar disorder, especially bipolar depression.
This study is a 4-month, randomized, parallel-group, double-blind, placebo-controlled pilot
study of a combination of cytidine and omega-3 fatty acids in 90 recently ill subjects with
bipolar disorder. During the 16 week period of the study, subjects are assigned to one of
three groups: 1) omega-3 fatty acids + cytidine supplementation, 2) omega-3 fatty acids
supplementation alone, and 3) placebo supplementation.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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