Bipolar disorder: leads from the molecular and cellular mechanisms of action of mood stabilisers
BackgroundNew research is dramatically altering our understanding of the molecular mechanisms underlying neuronal communication.AimTo elucidate the molecular mechanisms underlying the therapeutic effects of mood stabilisers.MethodResults from integrated clinical and laboratory studies are reviewed.ResultsChronic administration of lithium and valproate produced a striking reduction in protein kinase C (PKC) isozymes in rat frontal cortex and hippocampus. In a small study, tamoxifen (also a PKC inhibitor) had marked antimanic efficacy. Both lithium and valproate regulate the DNA binding activity of the activator protein 1 family of transcription factors. Using mRNA differential display, it was also shown that chronic administration of lithium and valproate modulates expression of several genes. An exciting finding is that of a robust elevation in the levels of the cytoprotective protein, bcl-2.ConclusionsThe results suggest that regulation of signalling pathways may play a major part in the long-term actions of mood stabilisers. Additionally, mood stabilisers may exert underappreciated neuroprotective effects.