title: Lithium increases plasma brain-derived neurotrophic factor in acute bipolar mania: a preliminary 4-week study.
abstract: Several studies have suggested an important role for brain-derived neurotrophic factor (BDNF) in the pathophysiology and therapeutics of bipolar disorder (BPD). The mechanisms underlying the therapeutic effects of lithium in BPD seem to involve a direct regulation of neurotrophic cascades. However, no clinical study evaluated the specific effects of lithium on BDNF levels in subjects with BPD. This study aims to investigate the effects of lithium monotherapy on BDNF levels in acute mania. Ten subjects with bipolar I disorder in a manic episode were evaluated at baseline and after 28 days of lithium therapy. Changes in plasma BDNF levels and Young Mania Rating Scale (YMRS) scores were analyzed. A significant increase in plasma BDNF levels was observed after 28 days of therapy with lithium monotherapy (510.9±127.1pg/mL) compared to pre-treatment (406.3±69.5pg/mL) (p=0.03). Although it was not found a significant association between BDNF levels and clinical improvement (YMRS), 87% of responders presented an increase in BDNF levels after treatment with lithium. These preliminary data showed lithium's direct effects on BDNF levels in bipolar mania, suggesting that short-term lithium treatment may activate neurotrophic cascades. Further studies with larger samples and longer period may confirm whether this biological effect is involved in the therapeutic efficacy of lithium in BPD.
authors.affiliation: Laboratory of Neurosciences-LIM27, Department and Institute of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
authors.forename: Rafael T
authors.initials: RT
authors.lastname: de Sousa
authors.forename: Martinus T
authors.initials: MT
authors.lastname: van de Bilt
authors.forename: Breno S
authors.initials: BS
authors.lastname: Diniz
authors.forename: Rodolfo B
authors.initials: RB
authors.lastname: Ladeira
authors.forename: Luis V
authors.initials: LV
authors.lastname: Portela
authors.forename: Diogo O
authors.initials: DO
authors.lastname: Souza
authors.forename: Orestes V
authors.initials: OV
authors.lastname: Forlenza
authors.forename: Wagner F
authors.initials: WF
authors.lastname: Gattaz
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Machado-Vieira
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000097:blood* / Q000188:drug therapy*; D019208:Brain-Derived Neurotrophic Factor / Q000097:blood*; D005260:Female; D006801:Humans; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D019208:Brain-Derived Neurotrophic Factor; D008094:Lithium