12- Week Open Label Treatment of Refractory Bipolar Depression

Inclusion Criteria: * diagnosis of bipolar disorder I or II according to M.I.N.I. * patient has signed informed consent * male, or female who is using effective birth control if of child bearing age * age 18 and above * currently in a depressed phase, with or without psychotic features, of the illness based on DSM-IV/MINI criteria * score of more than 19 on the MADRS * history of treatment refractory bipolar depression as defined by failure of the depressive episode to respond to a mood stabilizer alone or a combination of 2 or more mood stabilizers or a combination of a mood stabilizer and an antidepressant Exclusion Criteria: * current liver disease, * illness precluding the use of depakote er * patients who have been treated with a DEP and AZP combination in the past * Alcohol/drug dependence in the past one month * CNS neoplasms, demyelinating diseases, degenerative neurological condition or active CNS infection * history of seizure, known EEG with frank paroxysmal activity, known CT of brain showing gross structural abnormalities, cerebral vascular disease by history or structural brain damage from trauma * thyroid dysfunction * unstable general medical condition * require antipsychotic other than abilify