Biochemical Treatments for Bipolar Disorder

Doctor Ellen Leibenluft discusses biochemical treatments for biploar disorder, including pescriptions of lithium and Valproate, which target second-messenger systems.

There have been a number of studies to try to understand how the treatments in bipolar disorder work. In fact, one of the strategies that’s been used to try to understand what’s wrong biochemically in the brain in people with bipolar disorder is to trace the treatments backwards; look and say 'ok lithium works in bipolar disorder, what does lithium do in the brain?' or valproate [is] a similar kind of thing. Lithium appears to impact on a number of second messengers. In particular there’s been a lot of evidence in bipolar disorder that it’s not just the neurotransmitters that are on the cell’s surface that are involved in bipolar disorder but also the second messengers, which are the ones that get involved once the signal gets inside the cell. One particular such messenger for example is called GSK-3 and that has been implicated in the mechanism of action of lithium. Lithium seems to perhaps work on that particular messenger system, and that may have something to do with why it’s effective in bipolar disorder. That’s just one example though, there are many such others. Valproate for example works on the gabaergic system so that’s another neurotransmitter. Of course, the atypical anti psychotics which are effective in bipolar disorder work on both serotonergic and dopaminergic neurotransmitters, so that also implicates those systems in bipolar disorder.