title: Employing pharmacologic treatment of bipolar disorder to greatest effect.
abstract: Mechanisms of action, onset and duration of action, and interactions with other medications--all of these pharmacokinetic properties of pharmacologic agents affect the efficacy and safety of therapeutic regimens for bipolar disorder. For example, antiglutamatergic agents such as lamotrigine may relieve depression but have no impact on mania. Atypical antipsychotics with the dual effect of blocking dopamine and serotonin receptors in the brain decrease psychosis, mania, and, according to some preliminary indications, possibly depression. The impact of these properties has been borne out in clinical studies. Mood stabilizers such as lithium and valproate stabilize mood by significantly decreasing the manic and hypomanic symptoms of bipolar disorder, although they can have effects on depressive symptoms too. Lamotrigine stabilizes mood by reducing depression. The atypical anti-psychotics have been shown to be effective either as monotherapy or in combination with mood stabilizers.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305-6811, USA.
authors.forename: Alan F
authors.initials: AF
authors.lastname: Schatzberg
mesh_terms: D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000494:pharmacology / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000517:prevention & control / Q000523:psychology; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D006801:Humans; D000077213:Lamotrigine; D008094:Lithium / Q000494:pharmacology / Q000627:therapeutic use; D000077152:Olanzapine; D018079:Receptors, GABA / Q000187:drug effects; D017470:Receptors, Glutamate / Q000187:drug effects; D016896:Treatment Outcome; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use; D014635:Valproic Acid / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014150:Antipsychotic Agents; D018079:Receptors, GABA; D017470:Receptors, Glutamate; D014227:Triazines; D001569:Benzodiazepines; D014635:Valproic Acid; D008094:Lithium; D000077152:Olanzapine; D000077213:Lamotrigine