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Methylene Blue for Cognitive Dysfunction in Bipolar Disorder

This study has been completed.
Stanley Medical Research Institute
Information provided by:
Nova Scotia Health Authority Identifier:
First received: September 20, 2005
Last updated: March 28, 2008
Last verified: March 2008

While many bipolar patients treated with mood stabilizing medications experience improvement in their symptoms, some continue to have ongoing difficulties with concentration and memory. The purpose of this study is to look at whether these symptoms can be improved by adding the compound methylene blue to the treatment plan of patients who are already taking lamotrigine.

Methylene blue is an available 'over the counter medication' in Canada. It has been studied in the long-term treatment of mood symptoms in bipolar disorder. Several clinical studies done in bipolar disorder report that methylene blue has had positive effects on both cognition and mood. It is important to do further research in this area as we know that, for patients who continue to have ongoing cognitive difficulties, there is no recognized standard of care for bipolar patients who experience these type of deficits.

Condition Intervention Phase
Bipolar Disorder Drug: Methylene Blue Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double-Blind
Primary Purpose: Treatment
Official Title: Double-Blind Trial of Methylene Blue for Cognitive Dysfunction in Bipolar Disorder

Resource links provided by NLM:

Further study details as provided by Nova Scotia Health Authority:

Primary Outcome Measures:
  • Young Mania Rating Scale
  • Hamilton Depression Rating Scale (HAM-D), 17-item version Hamilton Rating Scale for Anxiety (HAM-A).
  • Clinical Global Impression Scale CGI-BP (41)
  • Affective Morbidity Index (42)

Secondary Outcome Measures:
  • California Verbal Learning Task and a process dissociation task. Two tasks will focus on selective attention, negative priming and inhibition of return tasks.
  • A visual backward masking task that has been well studied in patients with BD will be used.
  • Trails B will be administered as a test of executive function.

Estimated Enrollment: 40
Study Start Date: November 2003
Study Completion Date: October 2007
Detailed Description:
This is a double blind cross-over study. There are two dose ranges in this study. A cross over design means that some patients will start at one dose range and others with another. About half way through the study, patients will then be switched over to the other dose range. Patients partially stabilized on lamotrigine will be randomized to either subtherapeutic (16mg) or therapeutic (200mg) dose of methylene blue. This design is necessary because methylene blue stains urine and thus it is not possible to use a traditional placebo. Double-blind means that neither the doctor nor the patient will know which strength of study drug the patient will be on at what point in the study. The study will be conducted in three centres, each recruiting 20 subjects over a two-year period. The duration of the study is 6 months.

Ages Eligible for Study:   18 Years to 65 Years   (Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Men or women between the ages of 18 and 65 who meet both RDC and DSM-IV criteria for bipolar I or bipolar II disorder will be recruited.
  • All subjects will be interviewed using SADS interview (40) with added questions as to arrive at DSM-IV diagnoses as well.
  • The patients will be treated with lamotrigine as their main mood stabilizer. Patients recruited for the study will show at least partial response to prophylactic treatment with respect to the mood symptoms.
  • HAM-D (17 item) scores at study entry will be 15 or lower and Y MRS scores will be less than 15.

Exclusion Criteria:

  • Patients not able to give informed consent
  • Patients with active substance abuse or dependence or a history of such within the past two years
  • Physical illness, mainly liver and kidney disorders and G-6-PD deficiency
  • Subjects previously treated with methylene blue
  • Pregnant or breast-feeding women
  • Subjects who have had ECT within the past two years
  • Patients with known brain injury or loss of consciousness of duration greater than ten minutes
  • Subjects taking concurrent medications that are known to have cognitive effects (eg. beta blockers)
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00214877

Canada, Nova Scotia
CDHA- QE II Health Sciences Centre
Halifax, Nova Scotia, Canada, B3H-2E2
Canada, Ontario
St. Joseph's Healthcare
Hamilton, Ontario, Canada, L8N 3K7
Sponsors and Collaborators
Nova Scotia Health Authority
Stanley Medical Research Institute
Principal Investigator: Martin Alda, MD FRCPC Dalhousie University
  More Information Identifier: NCT00214877     History of Changes
Other Study ID Numbers: QE-RS/2002-173
Stanley Foundation # 02T-166
Study First Received: September 20, 2005
Last Updated: March 28, 2008

Keywords provided by Nova Scotia Health Authority:
methylene blue for cognitive dysfunction in bipolar disorder

Additional relevant MeSH terms:
Bipolar Disorder
Cognition Disorders
Pathologic Processes
Bipolar and Related Disorders
Mental Disorders
Neurocognitive Disorders
Methylene Blue
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action processed this record on August 16, 2017