title: An Untargeted Metabolomics Analysis of Antipsychotic Use in Bipolar Disorder.
abstract: BACKGROUND
  Second generation antipsychotic (SGA) use in bipolar disorder is common and has proven effective in short-term trials. There continues to be a lack of understanding of the mechanisms underlying many of their positive and negative effects in bipolar disorder. This study aimed to describe the metabolite profiles of bipolar subjects treated with SGAs by comparing to metabolite profiles of bipolar subjects treated with lithium, and schizophrenia subjects treated with SGAs.
  
  
  METHODS
  Cross-sectional, fasting untargeted serum metabolomic profiling was conducted in 82 subjects diagnosed with bipolar I disorder (n = 30 on SGAs and n = 32 on lithium) or schizophrenia (n = 20). Metabolomic profiles of bipolar subjects treated with SGAs were compared to bipolar subjects treated with lithium and schizophrenia subjects treated with SGAs using multivariate methods.
  
  
  RESULTS
  Partial lease square discriminant analysis (PLS-DA) plots showed separation between bipolar subjects treated with SGAs, bipolar subjects treated with lithium, or schizophrenia subjects treated with SGAs. Top influential metabolite features were associated with several pathways including that of polyunsaturated fatty acids, pyruvate, glucose, and branched chain amino acids.
  
  
  CONCLUSIONS
  The findings from this study require further validation in pre- and posttreated bipolar and schizophrenia subjects, but suggest that the pharmacometabolome may be diagnosis specific.
authors: Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, Michigan, USA.
authors: Kyle J
authors: KJ
authors: Burghardt
authors: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
authors: Simon J
authors: SJ
authors: Evans
authors: College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
authors: Kristen M
authors: KM
authors: Wiese
authors: Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.|College of Pharmacy, University of Michigan, Ann Arbor, Michigan, USA.
authors: Vicki L
authors: VL
authors: Ellingrod
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001714:Bipolar Disorder / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D018020:Lithium Compounds / Q000627:therapeutic use*; D008297:Male; D055432:Metabolomics / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D012559:Schizophrenia / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D018020:Lithium Compounds
keywords: antipsychotic; atypical; bipolar; metabolomics; untargeted