Emerging drugs for bipolar disorder

Abstract

Bipolar disorder is a relatively common condition characterised by recurrent episodes of mania and depression, and associated with high levels of morbidity and mortality. Although there have been substantial advances in the pharmacotherapeutics of this condition over the last 10 – 15 years, the benefits have been predominantly in terms of tolerability and safety, with no new treatments being demonstrated to be more effective than lithium – the prototype mood stabiliser. This article reviews current and emerging medications for bipolar disorder. Most of the emerging treatments in pharmaceutical industry developmental programmes are new or modified anticonvulsants or atypical antipsychotics. A number of possible future directions and challenges for the field are discussed. The treatment of bipolar disorder is unlikely to advance substantially until the causative pathogenetic molecular processes are elucidated.

Keywords::

• anticonvulsant
• antipsychotic
• bipolar depression
• bipolar disorder
• mania
• mood stabiliser

Conflicts of interests

P Mitchell has received honoraria from GlaxoSmithKline, Eli Lilly and AstraZeneca for lectures, and has served on an advisory board for Eli Lilly in the last 3 years. G Malhi has received funding for studies, lectures and/or advisory board membership from Pfizer, Eli Lilly, Sanofi Synthelabo, Wyeth and AstraZeneca.