Lithium Effects on the Brain's Functional and Structural Connectome in the Treatment of Bipolar Disorder

Inclusion criteria for BD subjects:

• ages 18-60 years (inclusive) and able to give voluntary informed consent;

• Satisfy criteria for Diagnostic and Statistical Manual 5th edition (DSM-V) for BD I or II, current Depressive Episode;

• 17-item Hamilton Depression Rating Scale (HAM-D) score >15 and <25;

• Young Mania Rating Scale (YMRS) < 8;

• no psychotropics in the last 2 weeks (if previously on fluoxetine then medication free for 5 weeks) OR on stable psychotropic medications for 12 weeks

• no lithium treatment for past 6 months;

• satisfy criteria to undergo an MRI scan based on MRI screening questionnaire;

• able to be managed as outpatients during the study as ascertained by Clinical Global Severity Scale < 5 (i.e., moderately ill) and no significant suicidal or homicidal ideation or gross disability.

Exclusion criteria for BD subjects are:

• meeting DSM-IV criteria for schizophrenia, schizoaffective disorder, or an anxiety disorder as

• a primary diagnosis;

• requiring inpatient treatment;

• meeting DSM-V criteria for substance dependence within the past 3 months, except caffeine or nicotine;

• positive urinary toxicology screening at screening visit;

• use of alcohol in the past 1 week;

• serious medical or neurological illness;

• current pregnancy or breast feeding;

• metallic implants or other contraindications to MRI.

Inclusion criteria for healthy subjects:

• ages 18-60 years and ability to give voluntary informed consent;

• no history of psychiatric illness or substance abuse or dependence;

• no significant family history of psychiatric or neurological illness in first degree relative;

• not currently taking any prescription or centrally acting medications;

• no use of alcohol in the past 1 week;

• and no serious medical or neurological illness.

Exclusion criteria for healthy subjects are:

• under 18 years of age;

• pregnant or breast-feeding;

• metallic implants or other contraindication to MRI.