Use of Ketosis in Modulating Metabolic Pathways in Bipolar Disorder

You may not be if

• Bipolar disorder diagnosis: Patients must have a Diagnostic Statistical Manual (DSM)-V diagnosis of bipolar disorder on the Structured Clinical Interview for DSM (SCID)
• Bipolar disorder symptoms: Patients must be stable and euthymic at time of consent and testing, documented by no hospitalizations in the prior 4 weeks
• Age: between 18-45 yrs for patients with bipolar disorder and age-matched controls
• Weight does not exceed 350lbs.
• Diameter does not exceed 60 cm when supine
• HbA1C \< 7%
• No non-MRI-compatible metal in the body (e.g., pacemaker, shrapnel, joint pins)
• No claustrophobia
• No history of significant head injury
• No history of electroconvulsive therapy (ECT) or transcranial magnetic stimulation (TMS) within the last 3 months
• No history of previous treatment with following procedures: vagus nerve stimulation, or deep brain stimulation
• Are not deemed a serious suicide or homicide risk
• No unstable medical illness, including cardiovascular, hepatic, renal, respiratory, endocrine, neurological, or hematological disease
• No seizure disorders
• Have the capacity to sign informed consent
• No current diagnosis or history of an alcohol or substance use disorder in the last 6 months or positive test for an illicit drug on the screening urine analysis (positive cannabis screen is not exclusionary): confirmed using urine toxicology test during the initial screening visit and before each MRI scan visit.
• For Healthy Volunteers Only: No psychotropic medication and no history of neurological disease
• Must have vision that is 20/20 or correctable to 20/20 with contact lenses
• No Type 1 diabetes mellitus
• No regular consumption of insulin and other antidiabetics, like Metformin®, GLP1-RA's and others.
• No kidney disease, as determined by medical history and/or blood work
• No history of heart attack or stroke
• No difficulty swallowing
• No myxedema
• No Pregnancy (pre-menopausal females): confirmed during medical screening and each MRI scan visit using a urine test
• No breastfeeding