An open-label trial of the glutamate-modulating agent riluzole in combination with lithium for the treatment of bipolar depression.
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.
Zarate
Carlos A
CA
Laboratory of Molecular Pathophysiology, National Institute of Mental Health, Bethesda, Maryland, USA. zaratec@mail.nih.gov
Quiroz
Jorge A
JA
Singh
Jaskaran B
JB
Denicoff
Kirk D
KD
De Jesus
Georgette
G
Luckenbaugh
David A
DA
Charney
Dennis S
DS
Manji
Husseini K
HK
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
D018691:Excitatory Amino Acid Antagonists; D019782:Riluzole; D008094:Lithium