The remaining 14 patients made up our final study sample. Their mean age ± standard deviation (SD) was 44 ±12, ranging from 21 to 58 years. The mean age ± SD of the ziprasidone-treated group

and the placebo-treated group was 48 ± 7 years and 40 ± 15 years respectively, with no significant difference between groups (t12 = 1.215, p = 0.248). Treatment groups did not differ in baseline sociodemographic characteristics (Table 1). Table 1. Sociodemographic characteristics of study participants by treatment. All patients met Diagnostic and Statistical Manual of Mental Disorders, SB431542 fourth edition (DSM-IV) criteria for BD, currently experiencing a MDE, confirmed using the Mini International Neuropsychiatric Inventory Inhibitors,research,lifescience,medical (MINI) [Sheehan Inhibitors,research,lifescience,medical et al. 1998]. At inclusion, all patients had a 17-item Hamilton Depression Rating Scale (HAMD-17) score greater than 16 [Hamilton, 1960]. Baseline blood work, electrocardiogram, and physical examination were performed for all patients. Women of child-bearing potential must have had a negative human chorionic gonadotropin test at enrolment, not be nursing, and be willing to use contraception. Exclusion criteria included current or past diagnosis of schizophrenia or dementia, manic/hypomanic/mixed episode at enrolment defined as a Young Mania

Rating Scale (YMRS) score greater than Inhibitors,research,lifescience,medical 12 [Young et al. 1978], substance dependence within 3 months prior to enrolment (excluding caffeine or nicotine), imminent risk of suicide or danger to themselves or others, known intolerance to ziprasidone, serious or inadequately treated medical illness,

history Inhibitors,research,lifescience,medical of seizures, previous enrolment in the study or enrolment in another treatment study within the previous 4 weeks, serum potassium/magnesium/calcium levels outside the normal range, marked liver function Inhibitors,research,lifescience,medical abnormalities, serological evidence of human immunodeficiency virus, acute or chronic hepatitis, recent acute myocardial infarction or uncompensated heart failure, and history of QT prolongation or if taking drugs known to prolong the QT interval. Patients could not be taking any other antipsychotic medication at the time of enrolment however or during the study. Further, all medication must have been at a stable dose for 4 weeks prior to enrolment, including benzodiazepines and other sleep aids. Concomitant medications can be seen in Table A1 of Appendix A. Patients who had been administered a depot antipsychotic medication within two dosing intervals of enrolment were also excluded. All patients gave written informed consent to participate in the study, which was approved by the local research ethics board, Health Canada and was registered [ClinicalTrials.gov identifier: NCT00835107]. Intervention Patients were randomly allocated using a randomization table to receive either placebo or ziprasidone. The oral capsule formulation of ziprasidone was dispensed, starting at 40 mg twice daily on day 1 and increased to 60 mg twice daily on day 2.