Project Summary

David E. Kemp, M.D. (Young Investigator 2008) of Case Western Reserve University, plans to study the effects of glucose-lowering drugs in the treatment of bipolar depression, comorbid metabolic syndrome, and immunoinflammatory activation. He will assess whether treatment with the glucose-lowering drugs pioglitazone or metformin can reduce acute depressive symptoms in patients with bipolar depression and comorbid metabolic syndrome. A secondary objective is to determine whether pioglitazone and/or metformin can be used to mitigate aspects of the metabolic syndrome such as obesity, elevated cholesterol levels, high blood pressure, and insulin resistance. It is hypothesized that pioglitazone and metformin, through their ability to increase insulin sensitivity and decrease the activation of immunoinflammatory cytokines, will simultaneously reduce both depressive symptoms and metabolic dysregulation. If effective, this trial will elucidate an alternative mechanism for the treatment of major depressive episodes in bipolar disorder that is predicated upon a shared pathophysiology between disorders of mood and disorders of metabolism.

Program Area: MOOD DISORDERS\Bipolar\Diabetes

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