||The current study was designed to examine the effects of uridine on depressive symptoms and neuropsychological test performance in depressed youth with bipolar disorder. Participants included 20 adolescents diagnosed with bipolar depression between the ages of 13 and 21. Additionally, this study sought to compare depressed bipolar youth to an age- and gender-matched unaffected comparison group. Therefore, 10 unaffected comparison adolescents also participated in the study. Recruitment of participants took place between 2014-2015 at a university-based psychiatric hospital. All youth and their families provided consent to participate in the study and were administered a diagnostic clinical interview. Mood was assessed weekly throughout the study using rating scales and neuropsychological tests were administered pre- and posttreatment. Bipolar participants were randomized to treatment with 500mg twice daily of uridine or placebo. Three participants were removed from the data analyses (2 in the uridine group and 1 in the placebo group) due to noncompliance. Results of the study demonstrated that uridine was tolerated and there were no serious adverse events. Three participants (33%) in the uridine vs. four participants (50%) in the placebo group showed reduced depression symptoms. However, there were no significant differences between the placebo and uridine groups on depression ratings from pre- to posttreament. Additionally, there were no differences in neurocognitive performance between the uridine or placebo groups from pre- to posttreatment. Importantly, treatment with uridine did not have any negative effects on neurocognitive performance; however, these results did not suggest any neuropsychological benefits either. Bipolar participants showed more impairment in attention, executive functioning, and processing speed than unaffected comparison participants at baseline. Academic experiences for bipolar participants were different from comparison participants and included more academic difficulties, discontinuations, and transfers to new schools and programs. Participants who reported academic difficulties or received special education services performed lower on attention, working memory, executive functioning, and processing speed tasks. Without more subjects, no firm conclusions can be drawn from the current findings; however, these findings suggest a need for further research into uridine treatment. Treatment of adolescent bipolar disorder is complex and treatments specifically designed for youth are needed.