Decision-Making in Bipolar Disorder
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Purpose
Forty subjects with bipolar disorder who are not receiving a mood-stabilizing medication for the treatment of their illness will participate in this study. The study aims to evaluate how decision-making is affected by treatment for bipolar disorder. Prior to beginning treatment, patients will complete questionnaires and a one-hour computer-administered assessment of decision-making. Differences between pre-post decision-making outcomes will be evaluated to examine whether the neuroeconomic concepts of risk aversion, loss aversion, risk tolerance and delay discounting are affected by treatment.
The overall goal of this study will be to identify whether decision-making in people with bipolar disorder is affected by treatment. Specifically the investigators will compare decision-making characteristics among bipolar patients prior to treatment with how these decision-making characteristics change over the course of 6 weeks of standard medication therapy for bipolar disorder. A total of 6 decision-making tasks and one control task will be administered via computer to eligible subjects. The investigators will evaluate decision-making under varying conditions of reward, risk, and uncertainty and over time. The investigators hypothesize that decision-making will improve across these assessments after 6 weeks of treatment.
| Condition | Intervention |
|---|---|
|
Bipolar Disorder |
Drug: Lithium, valproate, lamotrigine |
| Study Type: | Interventional |
| Study Design: | Allocation: Non-Randomized Intervention Model: Single Group Assignment Masking: Open Label |
| Official Title: | Decision-Making in Bipolar Disorder |
- Delay Equivalent [ Time Frame: 6 weeks ] [ Designated as safety issue: No ]Temporal discounting refers to the tendency to place less value on a reward as it moves away from the present time. Subjects will make decisions about whether to accept an immediate gain or loss verus a gain or loss occurring at some point in the future. Several iterations of choices are made using differing time frames. The results of these choices are then used to calculate the delay equivalent value.
| Estimated Enrollment: | 40 |
| Study Start Date: | May 2011 |
| Estimated Study Completion Date: | March 2014 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Mood stabilizer
Monotherapy treatment with either valproate, lithium or lamotrigine
|
Drug: Lithium, valproate, lamotrigine
Open label treatment per standard of care for bipolar disorder
Other Names:
|
Detailed Description:
Participation in this study will require three study visits over 6 weeks. Subjects will be evaluated with the Structured Diagnostic Interview for DSM-IV to confirm diagnosis. They will also be administered the Hamilton Anxiety and Depression Rating Scales. Eligible subjects will then complete questionnaires related to their symptoms as well as decision-making and risk-taking, including: the Barratt Impulsiveness Scale, the Spielberger State-Trait Anxiety Inventory, and the Flinders Decision-making questionnaire. The Montgomery-Asburg Depression Severity scale to assess changes in depression symptom severity and the Young Mania Rating Scale to assess changes in manic symptom severity, will be conducted at screening, baseline, and endpoint. Patients will also be given the Childhood Trauma Questionnaire at baseline visit, to assess for a history of childhood trauma. The subjects will then complete the computer-generated decision-making tasks. Upon completion, the study physician will initiate standard-of-care treatment with a mood stabilizer (either lithium, valproate, or lamotrigine). Standard-of-care laboratory testing and psychiatric follow-up will be performed during the patient's study participation. After six weeks of treatment with a mood stabilizer, patients will again complete the decision-making computerized assessment.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Male or female, age 18-65
- Primary DSM-IV TR Diagnosis of Bipolar Disorder, type I, II or NOS.
- Ability to visually read and understand English language
- Not currently taking any mood stabilizer or antipsychotic medication.
- Women of reproductive potential must be willing to take a medically approved form of birth control throughout the duration of the study.
Exclusion Criteria:
- Meet criteria for substance abuse or dependence within three months of the screening visit.
- Presents with a clinically significant suicide risk, as assessed by a study physician.
- Presence of any unstable or central nervous system-related medical illness that would interfere with cognition or participation.
- Women who are currently pregnant or lactating, or plan to become pregnant during the study.
Contacts and Locations| United States, Georgia | |
| Emory University Mood and Anxiety Disorders Program | Recruiting |
| Atlanta, Georgia, United States, 30306 | |
| Contact: Alison Oliver, MA 404-712-5095 alison.oliver@emory.edu | |
| Contact: Valerie Cruz 404-727-8474 vcruz@emory.edu | |
| Principal Investigator: Boadie Dunlop, MD | |
| Principal Investigator: | Boadie W Dunlop, MD | Emory University |
More Information
No publications provided
| Responsible Party: | Boadie W. Dunlop, Assistant Professor, Emory University |
| ClinicalTrials.gov Identifier: | NCT01463111 History of Changes |
| Other Study ID Numbers: | BDDM |
| Study First Received: | June 2, 2011 |
| Last Updated: | July 18, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Emory University:
|
Bipolar Manic depression Mood stabilizer Decision Neuroeconomics |
Additional relevant MeSH terms:
|
Bipolar Disorder Affective Disorders, Psychotic Mood Disorders Mental Disorders Lamotrigine Valproic Acid Lithium Carbonate Lithium Anticonvulsants Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Enzyme Inhibitors |
Molecular Mechanisms of Pharmacological Action GABA Agents Neurotransmitter Agents Physiological Effects of Drugs Antimanic Agents Tranquilizing Agents Central Nervous System Depressants Psychotropic Drugs Antipsychotic Agents Antidepressive Agents Calcium Channel Blockers Membrane Transport Modulators Cardiovascular Agents |
ClinicalTrials.gov processed this record on June 18, 2013