title: An open-label trial of the glutamate-modulating agent riluzole in combination with lithium for the treatment of bipolar depression.
abstract: BACKGROUND
  Preclinical and clinical evidence indicate that the glutamatergic system might play a role in the pathophysiology of mood disorders. This study was conducted to determine the efficacy and safety of riluzole, a glutamate-modulating agent, in bipolar depression.
  
  
  METHODS
  This was an 8-week add-on study of riluzole in combination with lithium in acutely depressed bipolar patients aged 18 years and older. After open treatment with lithium for a minimum period of 4 weeks, subjects who continued to have a Montgomery-Asberg Depression Rating Scale (MADRS) score of >/=20 received riluzole (50-200 mg/day) for 8 weeks.
  
  
  RESULTS
  Fourteen bipolar depressed patients entered the study. The linear mixed models for total MADRS score showed a significant treatment effect. No switch into hypomania or mania was observed. Overall, riluzole was well tolerated.
  
  
  CONCLUSIONS
  Although preliminary, these results suggest that riluzole might indeed have antidepressant efficacy in subjects with bipolar depression.
authors.affiliation: Laboratory of Molecular Pathophysiology, National Institute of Mental Health, Bethesda, Maryland, USA. zaratec@mail.nih.gov
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Zarate
authors.forename: Jorge A
authors.initials: JA
authors.lastname: Quiroz
authors.forename: Jaskaran B
authors.initials: JB
authors.lastname: Singh
authors.forename: Kirk D
authors.initials: KD
authors.lastname: Denicoff
authors.forename: Georgette
authors.initials: G
authors.lastname: De Jesus
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Dennis S
authors.initials: DS
authors.lastname: Charney
authors.forename: Husseini K
authors.initials: HK
authors.lastname: Manji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D019782:Riluzole / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018691:Excitatory Amino Acid Antagonists; D019782:Riluzole; D008094:Lithium