Brain Function in Depression and Insulin Resistance

Exclusion Criteria

• •\- History of mania or psychosis
• •Current suicidal ideation
• •Alcohol or substance abuse including cannabis use (current or in the last three months)
• •Early onset dementia of any etiology
• •Medical conditions with known significant effects on mood (e.g. Stroke or current hypothyroid state)
• •Unstable medical illnesses (e.g. Delirium, uncontrolled DM, uncontrolled cardiovascular illness)
• •Use of high doses of benzodiazepines (\> 2mg lorazepam/day equivalent)
• •Given the high comorbidity (80%) between MDD and anxiety disorders, participants with comorbid anxiety disorders will be included in the study as long as the clinical presentation suggests that depression precedes the onset of anxiety
• •Current or lifetime history of cancer, a chronic kidney or liver condition, type I or II diabetes
• •Current or lifetime use of glucocorticoid medications for \>1 month
• •Previous cerebrovascular accident or trauma involving loss of consciousness
• •Previous neurosurgery or history of a neurological condition
• •Pregnancy (females)
• •Claustrophobia
• •Ferrous metallic implants or any surgically placed medical device not cleared for safety at 3Tesla MRI strength
• •Positive Hepatitis C serology or other known viral infections that may induce insulin resistance
• •Peripheral vascular disease
• •Liver, kidney, or active blood disease
• •Peripheral neuropathy
• •Fasting glucose \> 126 mg/dL
• •Currently taking any medications that can alter glucose homeostasis (steroids, glucocorticoids, nicotinic acid)
• •Currently taking thiazolidinediones or insulin
• •Females currently on hormone replacement therapy (HRT) less than 6 months
• •Being left handed
• •Use of antidepressant medication within the past two weeks (six weeks fluoxetine)
• •Suicide risk
• •Current use of stimulants, antipsychotic medications, mood stabilizers, cognitive enhancers, statins, glucocorticoids, steroids, nicotinic acid, thiazolidinediones, insulin, metformin, any diabetes medications (e.g. gliptins), HIV medications.