Single-group treatment study (n=8) testing IV ketamine 0.5 mg/kg followed by an 8-week oral D-cycloserine maintenance course in patients with 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.
Single-group, standard-of-care followed by ketamine infusion (0.5 mg/kg IV) for responders, then 8-week oral D-cycloserine maintenance.
Ketamine hydrochloride 0.5 mg/kg infused over 40 minutes; non-responders do not proceed to DCS.
Standard of care: quetiapine, olanzapine-fluoxetine, or lurasidone per label; dosing titrated per clinician judgement.
D-cycloserine escalation: 250 mg ×3 days → 500 mg/day ×1 week → 750 mg/day ×1 week → 1000 mg/day for remainder (8-week course)