Abstract
In this article, we review preclinical studies investigating the role of protein kinase C (PKC) as it pertains to mania and effective antimanic agents. We then discuss clinical studies conducted with tamoxifen, a relatively selective PKC inhibitor, in acute bipolar mania. We conclude that PKC is an important target—arguably the first mechanistically distinct drug target for bipolar disorder. PKC holds considerable promise as a novel target for developing a new line of treatments for bipolar disorder.
Similar content being viewed by others
References and Recommended Reading
Judd LL, Akiskal HS, Schettler PJ, et al.: The long-term natural history of the weekly symptomatic status of bipolar I disorder. Arch Gen Psychiatry 2002, 59:530–537.
Goodwin FK, Jamison KR: Manic-Depressive Illness: Bipolar Disorders and Recurrent Depression, edn 2. New York: Oxford University Press; 2007.
Cerullo MA, Strakowski SM: The prevalence and significance of substance use disorders in bipolar type I and II disorder. Subst Abuse Treat Prev Policy 2007, 2:29.
Fossey MD, Otto MW, Yates WR, et al.: Validity of the distinction between primary and secondary substance use disorder in patients with bipolar disorder: data from the first 1000 STEP-BD participants. Am J Addict 2006, 15:138–143.
Zarate CA Jr, Tohen M, Fletcher K: Cycling into depression from a first episode of mania: a case-comparison study. Am J Psychiatry 2001, 158:1524–1526.
Sachs GS, Gardner-Schuster EE: Adjunctive treatment of acute mania: a clinical overview. Acta Psychiatr Scand Suppl 2007, 434:27–34.
Fagiolini A, Chengappa KN: Weight gain and metabolic issues of medicines used for bipolar disorder. Curr Psychiatry Rep 2007, 9:521–528.
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–S7.
Manji HK, Lenox RH: Ziskind-Somerfeld Research Award. Protein kinase C signaling in the brain: molecular transduction of mood stabilization in the treatment of manic-depressive illness. Biol Psychiatry 1999, 46:1328–1351.
Calabrese B, Halpain S: Essential role for the PKC target MARCKS in maintaining dendritic spine morphology. Neuron 2005, 48:77–90.
Craske ML, Fivaz M, Batada NN, Meyer T: Spines and neurite branches function as geometric attractors that enhance protein kinase C action. J Cell Biol 2005, 170:1147–1158.
Friedman E, Hoau Yan W, Levinson D, et al.: Altered platelet protein kinase C activity in bipolar affective disorder, manic episode. Biol Psychiatry 1993, 33:520–525.
Wang HY, Friedman E: Enhanced protein kinase C activity and translocation in bipolar affective disorder brains. Biol Psychiatry 1996, 40:568–575.
Manji HK, Bebchuk JM, Moore GJ, et al.: Modulation of CNS signal transduction pathways and gene expression by mood-stabilizing agents: therapeutic implications. J Clin Psychiatry 1999, 60(Suppl 2):27–39; discussion 40–41, 113–116.
Einat H, Yuan P, Szabo ST, et al.: Protein kinase C inhibition by tamoxifen antagonizes manic-like behavior in rats: implications for the development of novel therapeutics for bipolar disorder. Neuropsychobiology 2007, 55:123–131.
Harrison-Read PE: Models of mania and antimanic drug actions: progressing the endophenotype approach. J Psychopharmacol 2008 Jun 26 (Epub ahead of print).
Giambalvo CT: Protein kinase C and dopamine transport-2. Effects of amphetamine in vitro. Neuropharmacology 1992, 31:1211–1222.
Giambalvo CT: Protein kinase C and dopamine transport—1. Effects of amphetamine in vivo. Neuropharmacology 1992, 31:1201–1210.
Gnegy ME, Hong P, Ferrell ST: Phosphorylation of neuromodulin in rat striatum after acute and repeated, intermittent amphetamine. Brain Res Mol Brain Res 1993, 20:289–298.
Gould TD, Einat H: Animal models of bipolar disorder and mood stabilizer efficacy: a critical need for improvement. Neurosci Biobehav Rev 2007, 31:825–831.
Jordan VC: Molecular mechanisms of antiestrogen action in breast cancer. Breast Cancer Res Treat 1994, 31:41–52.
Bebchuk JM, Arfken CL, Dolan-Manji S, et al.: A preliminary investigation of a protein kinase C inhibitor in the treatment of acute mania. Arch Gen Psychiatry 2000, 57:95–97.
Young RC, Biggs JT, Ziegler VE, Meyer DA: A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978, 133:429–435.
Kulkarni J, Garland KA, Scaffidi A, et al.: A pilot study of hormone modulation as a new treatment for mania in women with bipolar affective disorder. Psychoneuroendocrinology 2006, 31:543–547.
Yildiz A, Guleryuz S, Ankerst DP, et al.: Protein kinase C inhibition in the treatment of mania: a double-blind, placebo-controlled trial of tamoxifen. Arch Gen Psychiatry 2008, 65:255–263.
Zarate CA Jr, Singh JB, Carlson PJ, et al.: Efficacy of a protein kinase C inhibitor (tamoxifen) in the treatment of acute mania: a pilot study. Bipolar Disord 2007, 9:561–570.
Tohen M: Clinical trials in bipolar mania: implications in study design and drug development. Arch Gen Psychiatry 2008, 65:252–253.
Keck PE Jr, Marcus R, Tourkodimitris S, et al.: A placebo-controlled, double-blind study of the efficacy and safety of aripiprazole in patients with acute bipolar mania. Am J Psychiatry 2003, 160:1651–1658.
Sysko R, Walsh BT: A systematic review of placebo response in studies of bipolar mania. J Clin Psychiatry 2007, 68:1213–1217.
Lopez M, Lelliott CJ, Tovar S, et al.: Tamoxifen-induced anorexia is associated with fatty acid synthase inhibition in the ventromedial nucleus of the hypothalamus and accumulation of malonyl-CoA. Diabetes 2006, 55:1327–1336.
Palmer JT, Payne JL: Stabilization of hypomania following initiation of tamoxifen. Am J Psychiatry 2008, 165:650–651.
Zarate CA Jr, Singh J, Manji HK: Cellular plasticity cascades: targets for the development of novel therapeutics for bipolar disorder. Biol Psychiatry 2006, 59:1006–1020.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
DiazGranados, N., Zarate, C.A. A review of the preclinical and clinical evidence for protein kinase C as a target for drug development for bipolar disorder. Curr Psychiatry Rep 10, 510–519 (2008). https://doi.org/10.1007/s11920-008-0081-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11920-008-0081-7