Beyond the therapeutic shackles of the monoamines: new mechanisms in bipolar disorder biology
Open accessAbstract
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.
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Today's psychiatric pharmaceuticals almost all target signaling by monoamine neuromodulators dopamine, serotonin, noradrenaline and/or histamine and their selective GPCR receptors.
“Today’s psychiatric pharmaceuticals almost all target signaling by the monoamine neuromodulators dopamine, serotonin, noradrenaline and/or histamine and their selective GPCR receptors (Data-Franco et al., 2017; Hamon and Blier, 2013; Millan et al., 2015; Urs et al., 2014).”
From Single-cell transcriptomic evidence for dense intracortical neuropeptide networks (2019) · cites this paper as Data-Franco et al., 2017
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Self-citationFerensztajn‐Rochowiak, E., Kucharska–Mazur, J., Samochowiec, J., Ratajczak, M. Z., Michalak, M., & RYBAKOWSKI, J. K. (2016) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2016.1174301 · Cited by 16 · see citing works
Add-on lamotrigine treatment and plasma glutamate levels in epilepsy: Relation to treatment response
Paraskevas, G. P., Triantafyllou, N. I., Kapaki, E. N., et al. (2006) · Epilepsy Research · doi:10.1016/j.eplepsyres.2006.05.004 · Cited by 12 · see citing works
Serra, G., Chiara, L. D., Manfredi, G., Koukopoulos, A. E., Sani, G., Girardi, P., Koukopoulos, A., & Serra, G. (2013) · Therapeutic Advances in Psychopharmacology · doi:10.1177/2045125313507737 · Cited by 12 · see citing works
Bosetti, F., Seemann, R., & Rapoport, S. I. (2002) · Neuroscience Letters · doi:10.1016/s0304-3940(02)00354-3 · Cited by 11 · see citing works
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Single-cell transcriptomic evidence for dense intracortical neuropeptide networks
Smith, S. J., Sümbül, U., Graybuck, L. T., Collman, F., Seshamani, S., Gala, R., Gliko, O., Elabbady, L., Miller, J. A., Bakken, T. E., et al. (2019) · eLife · doi:10.7554/elife.47889 · Cited by 156 · see citing works
Role of Protein Kinase C in Bipolar Disorder: A Review of the Current Literature
Saxena, A., Scaini, G., Bavaresco, D. V., Leite, C., Valvassoria, S. S., Carvalho, A. F., & Quevedo, J. (2017) · Complex Psychiatry · doi:10.1159/000480349 · Cited by 85 · see citing works
- Authors
- Data-Franco, J., Singh, A., Popovic, D., Ashton, M., Berk, M., Vieta, E., Figueira, M. L., & Dean, O. M.
- Affiliations
- University of Lisbon (PT)
- Barwon Health (AU)
- Centro de Investigación Biomédica en Red de Salud Mental (ES)
- Corresponding author
- Data-Franco, João
- Venue
- Progress in Neuro-Psychopharmacology and Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2017-01
- Volume
- 72
- Pages
- 73-86
- ISSN
- 0278-5846 (ISSN-L)
- OpenAlex
- W2520122909
- Cited by
- 38
- References
- 180
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 5 · 2019: 9 · 2018: 6 · 2017: 5 · 2016: 1
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- Locations
- Progress in Neuro-Psychopharmacology and Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- bipolar disorder, oxidative stress, glutamatergic neurotransmission, mitochondrial dysfunction, neuroinflammation, apoptosis, lithium, mood stabilizers, valproic acid, lamotrigine, quetiapine, N-acetylcysteine, celecoxib, ketamine, antioxidant defense, anti-inflammatory mechanism, new drugs
- MeSH terms
- Animals, Antidepressive Agents, Bipolar Disorder, Humans, Inflammation, Biogenic Monoamines, Signal Transduction, Oxidative Stress
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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