PET and MRI Brain Imaging of Bipolar Disorder

PATIENTS

BIPOLAR

Inclusion Criteria

• Bipolar patients suffering from a major depressive episode currently or recently (in the month prior to scanning). Patients on psychiatric medication will have failed their current regimen for the treatment of their depression: they will meet criteria for depression, be seeking treatment for it, and have been on an adequate dose of antidepressant or mood stabilizer (as defined by the Antidepressant Treatment Form-see Oquendo et al., 2003) for 4 weeks or more.
• Of sufficient severity to score at least 15 on the first 17 items of the Hamilton Depression Rating Scale or a score of 10 to 14 on the first 17 items of the Hamilton Depression Scale in conjunction with a score of at least 29 on the Beck Depression Inventory.
• Age range 18-65 years.
• Off all psychotropic and other types of drugs likely to interact with serotonin transporters and 5-HT1A receptors for at least 21 days. Allowed short-acting benzodiazepines for distressing anxiety or insomnia (up to 24 hours prior to each PET scan). Patients will be off neuroleptics for 3 weeks and off fluoxetine for 6 weeks prior to study. Off serotonin depleting drugs such as reserpine for 3 months. Patient will also be off anti-coagulant/anti-platelet treatment such as coumadin, with the exception of aspirin for 10 days.
• Willing to travel for PET scanning

Exclusion Criteria

• Other major psychiatric disorders such as schizophrenia, schizoaffective illness; current drug or alcohol abuse (within past 2 months), or drug or alcohol dependence = 900 mgs) for at least 4 weeks.
• Patient is unlikely to be able to tolerate medication washout
• Claustrophobia
• Blood donation within 8 weeks of the start of the study.
• History of bleeding disorder or are currently taking anticoagulants.

UNIPOLAR

Inclusion:

• Unipolar patients suffering from a major depressive episode currently or recently (in the month prior to scanning). Patients on psychiatric medication will have failed their current regimen for the treatment of their depression: they will meet criteria for depression, be seeking treatment for it, and have been on an adequate dose of antidepressant or mood stabilizer (as defined by the Antidepressant Treatment Form-see Oquendo et al., 2003) for 4 weeks or more.
• Of sufficient severity to score at least 15 on the first 17 items of the Hamilton Depression Rating Scale or a score of 10 to 14 on the first 17 items of the Hamilton Depression Scale in conjunction with a score of at least 29 on the Beck Depression Inventory.
• Age range 18-65 years.
• Off all psychotropic and other types of drugs likely to interact with serotonin transporters and 5-HT1A receptors for at least 21 days. Allowed short-acting benzodiazepines for distressing anxiety or insomnia (up to 24 hours prior to each PET scan). Patients will be off neuroleptics for 3 weeks and off fluoxetine for 6 weeks prior to study. Off serotonin depleting drugs such as reserpine for 3 months. Patient will also be off anti-coagulant/anti-platelet treatment such as coumadin, with the exception of aspirin for 10 days.
• Willing to travel for PET scanning

Exclusion:

• Other major psychiatric disorders such as schizophrenia, schizoaffective illness; current drug or alcohol abuse (within past 2 months), or drug or alcohol dependence = 900 mgs) for at least 4 weeks.
• Patient is unlikely to be able to tolerate medication washout
• Claustrophobia
• Blood donation within 8 weeks of the start of the study.
• History of bleeding disorder or are currently taking anticoagulants.
• Past unsuccessful treatment of Lithium of adequate dose and duration.

HEALTHY CONTROLS

Inclusion:

• No lifetime history of Axis I disorders
• Age range 18-65 years.
• Willing to travel for PET scanning.

Exclusion:

• Past or present alcohol/substance abuse or dependence; IV drug use or ecstasy use more than two times.
• A first-degree relative with history of major depression, schizophrenia, schizoaffective disorder, or s