Emerging drugs for bipolar disorder.
BACKGROUND
Bipolar disorder (BD) is a chronic mental illness characterized by the alternation of abnormal mood episodes with periods of remission. It results in important functional and psychosocial disability, as well as high rates of suicide. For many patients with BD, existing treatments do not provide sufficient management, and high rates of relapse and lingering residual symptoms are common.


METHODS
The present article is a comprehensive literature review focusing on novel pharmacological treatments for BD. The database PubMed (1990 - 2010) was searched, using the MeSH terms 'bipolar disorder' and 'therapeutics'. In addition, a manual search of bibliographical cross-referencing was performed. The papers obtained through the search strategy described above were manually screened for original articles, reviews and case reports emphasizing novel treatments for BD.


RESULTS
New pharmacological approaches are discussed here in detail, highlighting their possible mechanisms of action, their potential use in the different phases of the disease and their effect on specific symptoms, such as cognitive impairment.


CONCLUSIONS
Most of the emergent drugs for BD seem to be particularly promising in the treatment of bipolar depression, and there is a trend in the identification of drugs targeting less explored pathophysiological mechanisms found in BD. However, results regarding most of them are still preliminary, and additional studies are necessary to clarify their real role in the clinical management of BD.
Sanches
Marsal
M
UT Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, UT Houston Medical School, #3210, Houston, TX 77054, USA.
Newberg
Andrew R
AR
Soares
Jair C
JC
D000818:Animals; D018692:Antimanic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000503:physiopathology; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology; D016503:Drug Delivery Systems; D015195:Drug Design; D006801:Humans
D018692:Antimanic Agents; D014150:Antipsychotic Agents