Trehalose as add-on Therapy in Bipolar Depression

This is an investigator-initiated parallel group pilot study. All patients will give a signed informed consent prior to initiation of any study procedure. Study setting: This unicentric pilot study will be carried out at the Bipolar Disorder Programme of the Hospital Clinic, University of Barcelona. Over 700 Bipolar Disorder patients are currently treated by Bipolar Disorders Program of the Hospital Clinic and University of Barcelona, a tertiary center providing integrated care for patients from a specific catchment area as well as difficult-to-treat bipolar patients derived from all over Spain, as already described elsewhere. Patients are considered to be enrolled in the study when they sign the informed consent. Patients are considered to be randomized when they are assigned to receive either trehalose or maltose. It is expected that at least 60 patients will be randomly assigned in a 1:1 ratio of trehalose 70g to placebo (maltose 70g). Patients will receive no economic compensation for their participation in the study. Patients will be evaluated at baseline and at weeks 2, 4 and 6. At baseline, patients will receive explanations regarding the study; after signing the informed consent patients will be interviewed by the study psychiatrist and will be administered the study scales M.I.N.I. International Neuropsychiatric Interview-Plus (MINI-Plus), Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Rating scale for Depression (HAMD), Clinical Global Impression-Bipolar Disorder (CGI-BP), World Health Organization-well being (WHO-wb), Functioning Assessment Short Test (FAST), Cognitive complaints in bipolar disorder rating assessment (COBRA). Furthermore, patients will undergo routine blood analysis including glycaemia, thyroid function (T3, T4, TSH) as well as lithaemia, at baseline and at week 6. At weeks 2 and 4 patients will be administered MADRS, HAMD, CGI-BP, WHO-wb and FAST scales, and eventual side effects will be recorded. At week 6, patients will be interviewed and MADRS, HAMD, CGI-BP, and FAST and will be administered and side effects recorded. At the final visit (week 6), patients will undergo a clinical interview, followed by administration of MADRS, CGI-BP, WHO-wb, COBRA and FAST scales. Full blood analysis will be performed.