NMDA Antagonists in Bipolar Depression

Open single-group treatment design in patients with bipolar I or II depression: standard-of-care medication management, ketamine infusion (0.5 mg/kg IV over 40 minutes) for symptomatic subjects, and an 8-week oral D-cycloserine maintenance course for ketamine responders.

Primary aims are feasibility and safety of D-cycloserine as a maintenance strategy after ketamine; outcomes include depressive symptom change (HDRS), safety/tolerability, and magnetic resonance spectroscopy (MRS) measures.