Bipolar disorder affects about 2.8% of U.S. adults and involves alternating periods of depression and mania or hypomania. Current treatment typically combines mood stabilizers like lithium or valproate, antipsychotics, and sometimes antidepressants, but many people still experience breakthrough episodes. About a third don't respond adequately to available medications.
What's actually going on in research
Trials are testing faster-acting treatments for acute depression, including ketamine and psilocybin, along with new medications that target specific brain circuits. Researchers are studying brain stimulation methods, digital tools that predict mood episodes, and drugs that might prevent episodes rather than just treating them after they start. There's growing interest in personalized treatment based on genetic markers and brain imaging.
Rapid-acting antidepressants
Ketamine and related drugs can lift severe bipolar depression within hours instead of weeks. Studies are testing whether they can work safely without triggering mania.
Brain circuit targeting
New drugs aim at specific dopamine and glutamate pathways that appear dysregulated in bipolar disorder. This approach may offer better symptom control with fewer side effects than current medications.
Predictive monitoring
Smartphone apps and wearable devices track sleep, activity, and speech patterns to detect early signs of mood episodes. Trials are testing whether catching episodes early improves outcomes.
What to know before you search
Eligibility typically depends on bipolar type (I or II), current mood state, number of prior episodes, medications tried, and whether symptoms are treatment-resistant.
What types of trials are currently open
- Acute treatment trials — Testing medications or brain stimulation to end a current manic or depressive episode faster than standard treatments.
- Maintenance trials — Testing whether new medications can prevent future episodes in people whose mood is currently stable.
- Treatment-resistant trials — Testing options for people who haven't responded to at least two standard medications.
- Brain stimulation studies — Testing transcranial magnetic stimulation, deep brain stimulation, or other methods that use magnetic fields or electrodes to alter brain activity.
- Digital health studies — Testing apps and devices that monitor symptoms, deliver therapy techniques, or predict mood changes before they fully develop.
Recently added Bipolar Disorder trials
Receive a brain implant to treat severe bipolar depression
This study addresses a critical unmet need in the treatment of bipolar disorder by investigating whether Subcallosal Cingulate (SCC) Deep Brain Stimulation (DBS) can safely and effectively treat treatment-resistant bipolar depression without inducing manic switches. The researchers propose to accomplish this by incorporating monitoring of the SCC local field potentials (LFP) for depression tracking and amygdala LFP monitoring for mania prediction while treating Bipolar I patients with SCC DBS Stimulation. This approach could establish a new paradigm for personalized neuromodulation therapy that uses real-time neural monitoring to optimize outcomes while minimizing risks. By incorporating bilateral, dual-site LFP monitoring from both the SCC and amygdala, this research will allow the researchers to assess the therapeutic efficacy of continuous SCC-DBS and develop novel safety biomarkers that could transform the clinical management of DBS therapy in psychiatry. The findings will have immediate implications for clinical practice and will advance the study team's fundamental understanding of the neural circuits underlying mood regulation and dysregulation in bipolar disorder.
Complete brain scans before and after depression treatment
This study aims to investigate the neurophysiological and inflammatory changes associated with electroconvulsive therapy (ECT) in older age patients diagnosed with Major Depressive Episode, Major Depression, and Bipolar Disorder, using microstate analysis derived from resting-state electroencephalography (EEG) recordings. Within this scope, EEG recordings obtained before and after ECT will be compared to determine the relationships between changes in microstate parameters and inflammatory marker levels, clinical variables, and psychometric scale scores reflecting clinical improvement. Peripheral blood samples collected from the same patient group will be analyzed for complete blood count parameters as well as levels of interleukin-1 alpha (IL-1α), interleukin-1 beta (IL-1β), interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-α), soluble glycoprotein 130 (sgp-130), soluble interleukin-6 receptor (sIL-6R), interferon gamma-induced protein 10 kDa (IP-10), and C-reactive protein (CRP). In addition, inflammatory indices, including the Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Monocyte-to-Lymphocyte Ratio (MLR), will be calculated. The association between baseline levels of these biomarkers and treatment response will be evaluated. Moreover, changes in biomarker levels following ECT will be statistically examined in relation to clinical scale scores and EEG microstate parameters. Although microstate analysis and inflammatory biomarkers have each been extensively investigated in psychiatric disorders, studies evaluating these two biomarkers together, particularly with the inclusion of healthy control participants, in the older age population remain limited. In this regard, the present study aims to evaluate the effects of ECT on older age patients using objective neurophysiological indicators, contribute to the understanding of the pathophysiology of depression at the level of brain networks, and provide a scientific basis for the development of personalised treatment approaches in the future.
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