PURPOSE: The primary aim of this study is to determine if citicoline treatment is associated with less cocaine use than placebo in outpatients with Bipolar I Disorder and cocaine dependence. Citicoline is a nutritional supplement that appears to have neuroprotective and cognitive-enhancing properties. The second aim of the study is to determine if citicoline treatment is associated with greater improvement in executive functioning than placebo in outpatients with Bipolar I Disorder and cocaine dependence.

ELIGIBILITY: The study is open to men and women age 18-65 years old, English or Spanish speaking.  Participants must meet the diagnosis of Bipolar I Disorder, depressed or mixed phase, which will be confirmed by interview. Participants must also meet a current diagnosis of cocaine dependence, cocaine use (by self-report) within 7 days prior to baseline, and a cocaine-positive urine at baseline. Participants will also be taking a mood stabilizer, such as lithium, divalproex/valproic acid, oxcarbazepine, or lamotrigine at a stable dose for > 14 days.

BACKGROUND:  The negative impact of substance abuse on bipolar disorder is well documented. Studies report decreased quality of life, increased hospitalization, and lower rates of recovery during hospitalization in bipolar patients with substance abuse. In addition, aggression and violence were significantly greater in bipolar disorder patients with a history of substance abuse. Substance abuse is also associated with medication non-compliance in patients with bipolar disorder.

Frequently Asked Questions
Q: What medications must I be on to participate in this study?
A: A mood stabilizer, such as lithium, divalproex/valproic acid, oxcarbazepine, or lamotrigine at a stable dose for > 14 days

Q: How long can I expect to be in this study?
A: A person is expected to participate in the study for 12 weeks, with weekly visits.

Q: Will I be paid if I take part in this study?
A: Yes, monetary compensation will be provided for time and travel.