Emerging drugs for bipolar disorder

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.

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.

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.

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.