Use of Ketosis in Modulating Metabolic Pathways in Bipolar Disorder

Exclusion Criteria

• •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