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Cytidine and Omega-3 Fatty Acids in Bipolar Disorder

Phase 2
Completed
Conditions
Bipolar Disorder
Interventions
Dietary Supplement: cytidine
Drug: placebo
Dietary Supplement: omega-3 fatty acids
Registration Number
NCT00854737
Lead Sponsor
Mclean Hospital
Brief Summary

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.

Detailed Description

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.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
90
Inclusion Criteria
  • bipolar disorder
  • mood episode within past year
  • stable medication regimen
Exclusion Criteria
  • primary psychiatric disorder other than bipolar disorder
  • significant suicide or homicide risk
  • unstable medical conditions
  • current or planned pregnancy
  • lactose intolerance
  • medications affecting lipid absorption or metabolism
  • clozapine treatment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1cytidineOmega-3 fatty acid and cytidine supplementation
1omega-3 fatty acidsOmega-3 fatty acid and cytidine supplementation
2omega-3 fatty acidsomega-3 fatty acid supplementation
placeboplaceboplaceno or sugar pill
Primary Outcome Measures
NameTimeMethod
Mood Rating Scale Scoresweekly-biweekly
Secondary Outcome Measures
NameTimeMethod
Study Retention Time4 months
functional recoveryweekly-biweekly

Trial Locations

Locations (2)

McLean Hospital

🇺🇸

Belmont, Massachusetts, United States

Jersey Shore University Medical Center

🇺🇸

Neptune, New Jersey, United States

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