Potential novel treatments for bipolar depression

Abstract

Existing pharmacological treatments for bipolar disorder (BPD), a severe recurrent mood disorder, is in general insufficient for many patients. Despite adequate doses and treatment duration, many individuals afflicted with this disease continue to experience mood episode relapses, residual symptoms, and functional impairment. In contrast to the manic phase of the illness where a fairly large variety of effective treatments are available, in bipolar depression effective therapeutics are scarce. This is especially troubling because the long-term course of BPD is dominated by recurrent depressive episodes and lingering depressive symptoms rather than hypomanic/manic episodes. Novel therapeutics — that is, drugs that do not include the existing antipsychotic, antiepileptic, and antidepressant medications — currently being studied to determine their efficacy and safety in bipolar depression include modafinil, pramipexole, N-acetyl cysteine (NAC), scopolamine, agomelatine, riluzole, memantine, ketamine, AMPA potentiators, ketoconazole, mifepristone, celecoxib, creatine, and uridine RG2417. Further study of these drugs will investigate their clinical utility in bipolar depression, and further our understanding of relevant drug targets. (PsycINFO Database Record (c) 2019 APA, all rights reserved)