Exploring the Effects of Coenzyme Q10 on Bioenergetics Metabolism in Geriatric Bipolar Depression: A 31 Phosphorus MR Spectroscopy Study

Research Design and Methods:

Bipolar Depressed Subjects:

The Bipolar Depressed group will consist of 10 subjects (for the purposes of this study we would like to be able to recruit up to 30 subjects, with the goal of getting 10 to complete the protocol), ages 55-89, meeting DSM IV-TR criteria for bipolar disorder, current episode depressed, with depression severity rated by the MADRS and the Clinical Global Impression of severity scale (CGI). The Young Mania Rating Scale (YMRS) will be used to assess concomitant manic symptoms and neuropsychological measures to assess cognitive status. Subjects with any current or previous Axis I disorder diagnosis other than Bipolar Disorder, including dementia, unstable medical illness or any contraindications to magnetic resonance imaging (MRI) will be excluded. Subjects may be concurrently prescribed other psychotropic medications, but dosages must be unchanged for one week prior to study entry and subjects must be willing to continue these medications during the study. All subjects must be able to provide written informed consent. Furthermore, subjects will be asked to complete a demographic information form.

Recruitment will take place through referrals from the McLean Hospital Geriatric Psychiatry Inpatient Service, Geriatric Psychiatry Outpatient Program: SAGE (Seniors Aging Gracefully Everyday) the Geriatric Psychiatry Outpatient Clinic, other inpatient, partial and outpatient psychiatric programs at McLean Hospital, the Cambridge Health Alliance, local geriatricians, the Harvard Division on Aging, local retirement communities, community psychiatrists, Partners Community Health Care PCP's, Massachusetts General Hospital and Brigham and Women's PCP network and similar external programs, as well as through radio and internet advertisements. We have obtained permission from the directors of both the Inpatient Service (Older Adult Unit) and Geriatric Psychiatry Outpatient Program (SAGE Program) to have a research assistant look through patient charts to identity eligible subjects. Once a potential subject has been identified, study staff will discuss the possibility of study participation with the patient's doctor to see if the study would be appropriate. If the doctor agrees about the patient's eligibility, the doctor will discuss the study with the patient and refer patients who are interested in participating to a member of our study staff.

Inclusion Criteria: