No Benefit Seen With Pioglitazone in Patients With Bipolar Depression

sad girl sitting on couch
sad girl sitting on couch
Study findings do not support the antidepressant efficacy of pioglitazone in the treatment of bipolar depression.

The use of pioglitazone showed no antidepressant effects in patients with bipolar depression, according to study results published in the Journal of Affective Disorders.

Researchers conducted a double-blind placebo-controlled randomized study of 37 patients with bipolar disorder. Study participants were randomly assigned to receive either pioglitazone (n=17) or placebo (n=20) for a total of 8 weeks. Drug therapy was started at 15 mg/d titrated to a maximum of 45 mg/d. The primary outcome measured was the change in depressive symptom score from start of therapy to 8 weeks. In addition, changes in symptom score were measured using the 30 item Inventory of Depressive Symptomatology, Clinician Rated (IDS-C30).

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After analysis, the researchers found no statistically significant difference between patients given pioglitazone vs placebo (mean reduction, −6.59 vs −11.63; P =.056). With respect to safety, no clinically meaningful adverse effects were seen in the study participants.

The primary limitations of the study were the concurrent use of psychotropic drugs and the small sample size. Researchers also noted that treatment duration was limited to 8 weeks, which might not be long enough for pioglitazone to show its full efficacy, and wrote, “A longer follow-up may be warranted in future studies.”

“[The] current study does not support the antidepressant efficacy of pioglitazone in the treatment of bipolar depression, however, given the small sample size, no definitive conclusions can be drawn,” the researchers wrote.

Disclosures: Multiple authors declare affiliations with the pharmaceutical industry. Please see original reference for authors’ disclosures.


Aftab A, Kemp DE, Ganocy SJ, et al. Double-blind, placebo-controlled trial of pioglitazone for bipolar depression. J Affect Disord. 2019;245:957-964.