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Trends in Clinical Practice

Treatment of bipolar disorder: New perspectives

, FRCPC , MD, , &
Pages 186-196 | Received 22 Jan 2008, Published online: 08 Jul 2009

Figures & data

Table I.  Key features of bipolar disorder

Table II.  Factors to consider for selecting optimal long-term treatment

Figure 1.  A simplified diagram of the most important pathways regulated by mood-stabilizing medications. Full lines indicate stimulatory and dotted lines inhibitory effects. A number of these pathways converge on regulatory proteins and transcription factors, which through fine-tuning of balance between pro- and antiapoptotic mechanisms regulate neurogenesis, cell survival, and resilience to damage through corticosteroids etc. The effects of available medications, however, affect these regulatory proteins/transcription factors indirectly, mostly through actions on release of neurotransmitters. Novel medications should interfere with these pathways further ‘downstream’.

Figure 1.  A simplified diagram of the most important pathways regulated by mood-stabilizing medications. Full lines indicate stimulatory and dotted lines inhibitory effects. A number of these pathways converge on regulatory proteins and transcription factors, which through fine-tuning of balance between pro- and antiapoptotic mechanisms regulate neurogenesis, cell survival, and resilience to damage through corticosteroids etc. The effects of available medications, however, affect these regulatory proteins/transcription factors indirectly, mostly through actions on release of neurotransmitters. Novel medications should interfere with these pathways further ‘downstream’.

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