title: Chronic treatment with both lithium and sodium valproate may normalize phosphoinositol cycle activity in bipolar patients.
abstract: BACKGROUND
  It has been proposed that lithium may be clinically effective due to its actions on the phosphoinositol second messenger system (PI-cycle). Studies have also suggested that untreated manic patients may have raised myo-inositol and phosphomonoester (PME) concentrations and also that unmedicated euthymic bipolar patients may have lowered PME concentrations. The objective of the present study was to test the hypothesis that chronic treatment with either lithium or sodium valproate in patients with bipolar mood disorder leads to a normalization in the activity of the PI-cycle.
  
  
  METHODS
  This study had two parts each with different MRS methodology. The first part compared healthy controls (n = 19) with euthymic bipolar patients who were taking either lithium (n = 16) or sodium valproate (n = 11) using both (1)H-MRS and (31)P-MRS. In the second part we examined a separate group of euthymic bipolar disorder patients taking sodium valproate (n = 9) and compared these with age and sex-matched healthy controls (n = 11) using (1)H-MRS.
  
  
  RESULTS
  Both studies showed that there were no differences in either myo-inositol or phosphomonoester (PME) concentrations between controls and patients taking either medication.
  
  
  CONCLUSIONS
  These findings examine two key components of the PI-cycle in treated euthymic bipolar (myo-inositol and PME concentrations). The results from this study are consistent with the suggestion that chronic treatment with either lithium or sodium valproate in bipolar patients may normalize PI-cycle functioning.
authors.affiliation: Department of Psychiatry, University of Alberta, Edmonton, Alberta, Canada. peter.silverstone@ualberta.ca
authors.forename: Peter H
authors.initials: PH
authors.lastname: Silverstone
authors.forename: Ren H
authors.initials: RH
authors.lastname: Wu
authors.forename: Tina
authors.initials: T
authors.lastname: O'Donnell
authors.forename: Michele
authors.initials: M
authors.lastname: Ulrich
authors.forename: Sheila J
authors.initials: SJ
authors.lastname: Asghar
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Hanstock
mesh_terms: D000328:Adult; D000465:Algorithms; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000378:metabolism; D001923:Brain Chemistry / Q000187:drug effects; D005260:Female; D005625:Frontal Lobe / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D007294:Inositol / Q000378:metabolism; D008094:Lithium / Q000627:therapeutic use*; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D010716:Phosphatidylinositols / Q000378:metabolism*; D011569:Psychiatric Status Rating Scales; D013702:Temporal Lobe / Q000187:drug effects / Q000378:metabolism; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D018692:Antimanic Agents; D010716:Phosphatidylinositols; D007294:Inositol; D014635:Valproic Acid; D008094:Lithium