RCT of Brain Longitudinal Biomarker Study (OPT-Neuro RCT)

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• Dementia; patients screened out due to possible dementia will be referred to a local Memory Clinic or back to their clinician for evaluation to clarify the presence or absence of dementia.
• Lifetime diagnosis of bipolar I or II disorder, schizophrenia, schizoaffective disorder, schizophreniform disorder, delusional disorder, or current psychotic symptoms.
• High risk for suicide (e.g. active Suicidal ideations (SI) and or current/recent intent or plan)). Urgent psychiatric referral will be made in these cases.
• Non-correctable, clinically significant sensory impairment (e.g., cannot hear well enough to cooperate with interview).
• Unstable medical illness, including delirium, uncontrolled diabetes mellitus, hypertension, hyperlipidemia, or cerebrovascular or cardiovascular risk factors that are not under medical management.
• Moderate to severe substance or alcohol use disorder, as determined by study physician.
• Seizure disorder.
• Parkinson's Disease

• Men and women aged 60 and older, with approximately equal proportions aged 60-70 and 70+.
• Current Major Depressive Disorder (MDD), single or recurrent, as diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria.
• Failure to respond adequately to two or more antidepressant treatment trials of recommended dose and length (approximately 12 weeks).
• PHQ-9 score of 10 or higher.