Abstract
Drugs successfully applied in the treatment of bipolar disorder have been termed mood stabilizers and include different pharmacological classes: antipsychotic agents, anti-convulsants, and lithium.
Contrary to the development of antipsychotic and antidepressive drugs, no drug has been developed on biological models or hypotheses of bipolar disorder. The most commonly applied drug lithium has been introduced based on findings by serendipity, and no unique pharmacological mechanism of mood stabilization was identified so far. However, several mood stabilizers share a modulation of inositol- and GSK-3β-mediated pathways leading to neuroprotection and increased neuronal plasticity.
Future hypothesis-driven drug development is presently limited since (I) bipolar disorder results from a large spectrum of molecular mechanisms also associated and shared with other psychiatric morbidities and (II) animal models allow to address only neurobiological aspects well conserved across species.
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References
Alda M. Lithium in the treatment of bipolar disorder: pharmacology and pharmacogenetics. Mol Psychiatry. 2015;20(6):661–70.
Aringhieri S, et al. Molecular targets of atypical antipsychotics: from mechanism of action to clinical differences. Pharmacol Ther. 2018;192:20. Ahead of print
Aubry J-M, et al. Early effects of mood stabilizers on the Akt/GSK-3beta signaling pathway and on cell survival and proliferation. Psychopharmacology. 2009;205(3):419–29.
Beaulieu J-M, Gainetdinov RR. The physiology, signaling, and pharmacology of dopamine receptors. Pharmacol Rev. 2011;63(1):182–217.
Beaulieu J-M, et al. A beta-arrestin 2 signaling complex mediates lithium action on behavior. Cell. 2008;132(1):125–36.
Berridge MJ, Downes CP, Hanley MR. Neural and developmental actions of lithium: a unifying hypothesis. Cell. 1989;59(3):411–9.
Cade JF. Lithium salts in the treatment of psychotic excitement. Med J Aust. 1949;2(10):349–52.
Chiu C-T, et al. Therapeutic potential of mood stabilizers lithium and valproic acid: beyond bipolar disorder. Pharmacol Rev. 2013;65(1):105–42.
Coppen A, Shaw DM. The distribution of electrolytes and water in patients after taking lithium carbonate. Lancet. 1967;2(7520):805–6.
Davis KL, et al. Dopamine in schizophrenia: a review and reconceptualization. Am J Psychiatry. 1991;148(11):1474–86.
Ferré S, et al. G protein-coupled receptor oligomerization revisited: functional and pharmacological perspectives. Pharmacol Rev. 2014;66(2):413–34.
Fribourg M, et al. Decoding the signaling of a GPCR heteromeric complex reveals a unifying mechanism of action of antipsychotic drugs. Cell. 2011;147(5):1011–23.
Ghasemi M, Dehpour AR. The NMDA receptor/nitric oxide pathway: a target for the therapeutic and toxic effects of lithium. Trends Pharmacol Sci. 2011;32(7):420–34.
Gurvich N, Klein PS. Lithium and valproic acid: parallels and contrasts in diverse signaling contexts. Pharmacol Ther. 2002;96(1):45–66.
Hiemke C, et al. Consensus guidelines for therapeutic drug monitoring in neuropsychopharmacology: update 2017. Pharmacopsychiatry. 2018;51(1–02):9–62.
Johannessen CU, Johannessen SI. Valproate: past, present, and future. CNS Drug Rev. 2003;9(2):199–216.
Jope RS. Lithium and GSK-3: one inhibitor, two inhibitory actions, multiple outcomes. Trends Pharmacol Sci. 2003;24(9):441–3.
Kapur S, Seeman P. Does fast dissociation from the dopamine d(2) receptor explain the action of atypical antipsychotics? A new hypothesis. Am J Psychiatry. 2001;158(3):360–9.
Kenakin T. Efficacy at G-protein-coupled receptors. Nat Rev Drug Discov. 2002;1(2):103–10.
Kenakin TP. Cellular assays as portals to seven-transmembrane receptor-based drug discovery. Nat Rev Drug Discov. 2009;8(8):617–26.
Ketter TA, Manji HK, Post RM. Potential mechanisms of action of lamotrigine in the treatment of bipolar disorders. J Clin Psychopharmacol. 2003;23(5):484–95.
López-Muñoz F, et al. A history of the pharmacological treatment of bipolar disorder. Int J Mol Sci. 2018;19(7):2143.
Manji HK, Lenox RH. Signaling: cellular insights into the pathophysiology of bipolar disorder. Biol Psychiatry. 2000;48(6):518–30.
Manji HK, Zarate CA. Molecular and cellular mechanisms underlying mood stabilization in bipolar disorder: implications for the development of improved therapeutics. Mol Psychiatry. 2002;7 Suppl 1(S1):S1–7.
Masri B, et al. Antagonism of dopamine D2 receptor/beta-arrestin 2 interaction is a common property of clinically effective antipsychotics. Proc Natl Acad Sci U S A. 2008;105(36):13656–61.
Miyamoto S, et al. Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Mol Psychiatry. 2012;17(12):1206–27.
Oruch R, et al. Lithium: a review of pharmacology, clinical uses, and toxicity. Eur J Pharmacol. 2014;740(C):464–73.
Pisanu C, et al. Understanding the molecular mechanisms underlying mood stabilizer treatments in bipolar disorder: potential involvement of epigenetics. Neurosci Lett. 2018;669:24–31.
Rogawski MA, Löscher W. The neurobiology of antiepileptic drugs for the treatment of nonepileptic conditions. Nat Med. 2004a;10(7):685–92.
Rogawski MA, Löscher W. The neurobiology of antiepileptic drugs. Nat Rev Neurosci. 2004b;5(7):553–64.
Sarker S, et al. The high-affinity binding site for tricyclic antidepressants resides in the outer vestibule of the serotonin transporter. Mol Pharmacol. 2010;78(6):1026–35.
Schloesser RJ, Martinowich K, Manji HK. Mood-stabilizing drugs: mechanisms of action. Trends Neurosci. 2012;35(1):36–46.
Schou M. Biology and pharmacology of the lithium ion. Pharmacol Rev. 1957;9(1):17–58.
Spirtes MA. Lithium levels in monkey and human brain after chronic, therapeutic, oral dosage. Pharmacol Biochem Behav. 1976;5(2):143–7.
Williams RSB, et al. A common mechanism of action for three mood-stabilizing drugs. Nature. 2002;417(6886):292–5.
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Hommers, L. (2022). Mood Stabilizers: Pharmacology and Biochemistry. In: Riederer, P., Laux, G., Nagatsu, T., Le, W., Riederer, C. (eds) NeuroPsychopharmacotherapy. Springer, Cham. https://doi.org/10.1007/978-3-030-62059-2_37
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