Beyond the therapeutic shackles of the monoamines: New mechanisms in bipolar disorder biology

作者：Data Franco Joao^*; Singh Ajeet; Popovic Dina; Ashton Melanie; Berk Michael; Vieta Eduard; Figueira M L; Dean Olivia M

来源：Progress in Neuro-Psychopharmacology and Biological Psychiatry, 2017, 72: 73-86.

DOI：10.1016/j.pnpbp.2016.09.004

• Bipolar disorder
• Novel therapy
• Oxidative stress
• Inflammation
• Mitochondrial dysfunction
• Neurogenesis
• Minocycline

Multiple novel biological mechanisms putatively involved in the etiology of bipolar disorders are being explored. These include oxidative stress, altered glutamatergic neurotransmission, mitochondrial dysfunction, inflammation, cell signaling, apoptosis and impaired neurogenesis. Important clinical translational potential exists for such mechanisms to help underpin development of novel therapeutics -much needed given limitations of current therapies. These new mechanisms also help improve our understanding of how current therapeutics might exert their effects. Lithium, for example, appears to have antioxidant, immunomodulatory, signaling, anti-apoptotic and neuroprotective properties. Similar properties have been attributed to other mood stabilizers such as valproate, lamotrigine, and quetiapine. Perhaps of greatest translational value has been the recognition of such mechanisms leading to the emergence of novel therapeutics for bipolar disorders. These include the antioxidant N-acetylcysteine, the anti-inflammatory celecoxib, and ketamine -with effects on the glutamatergic system and microglial inhibition. We review these novel mechanisms and emerging therapeutics, and comment on next steps in this space.

• 出版日期2017-1-4
• 单位迪肯大学