Bipolar disorders systems

Divalproex sodium is comprised of sodium valproate and valproic acid. The delayed-release and extended-release formulations are converted in the small intestine into valproic add, which is the systemically absorbed form. It was developed as an antiepileptic drug, but also has efficacy for mood stabilization and migraine headaches. It is FDA-approved for the treatment of the manic phase of bipolar disorder. It is generally equal in efficacy to lithium and some other drugs for bipolar mania. It has particular utility in bipolar disorder patients with rapid cycling, mixed mood features, and substance abuse comorbidity. Although not FDA-approved for relapse prevention, studies support this use, and it is widely prescribed for maintenance therapy. Divalproex can be used as monotherapy or in combination with lithium or an antipsychotic drug.31... 

The serotonergic system has long been thought to play a role in major depression and bipolar disorders, although the exact mechanisms are yet to be determined 889... 

Blumberg, H. P., Charney, D. S. and Krystal, J. H. Frontotemporal neural systems in bipolar disorder. Semin. Clin. Neuropsychiatry 7 243-254, 2002. 

Lithium is an important element in many industries (Bach 1985). Lithium is used medically as a treatment for bipolar disorders (Schou 1988). Lithium toxicity, especially to the renal system, is problematical. Estimating systemic elemental mass balance, especially for patients receiving oral Li dosing, is important, and is one area in which Li isotope ratios are... 

A great many physical and mental disorders develop because of a malfunction in the nervous system. Some examples are Alzheimer s disease, schizophrenia, Parkinson s disease, Huntington s chorea, and bipolar disorder. Most of the effects produced by recreational drugs, such as alcohol, heroin, and cocaine, are also a result of changes in the way the nervous system functions. Today, scientists have a reasonably good understanding of the way in which the nervous system operates and how many types of chemicals affect this operation. 

Carbamazepine produces complex effects in a variety of neurotransmitters, receptors, and second messenger and neuropeptide systems (Post et al. 1992, 1994a). Determining which of these effects is most closely associated with its psychotropic properties in bipolar disorder and which of these or other effects may be responsible for the augmentation response in combination therapy with dihydropyridine L-type CCBs remains to be further evaluated. However, discussion of two possibilities might be beneficial. One possibility, of course, is that actions of carbamazepine unrelated to calcium dynamics account for its augmenting effects with nimodipine. The plethora of these other... 

Considerable effort over the years has been expended to identify specific neurotransmitter systems that might mediate the therapeutic action of lithium in the treatment of patients with bipolar disorder. As we critically review the evidence from these studies, it will be evident that lithium can affect a variety of neurotransmitter systems, but these effects may be secondary to more fundamental modulation of signal transduction responsible for regulating the balance of signaling in critical regions of the brain. 

Dubovsky SL, Murphy J, Christiano J, et al The calcium second messenger system in bipolar disorders data supporting new research directions. J Neuropsychiatry Chn Neurosci 4 3-14, 1992b... 

Chlorpromazine Blockade of D2 receptors >> 5 2 receptors .-Receptor blockade (fluphenazine least) muscarinic (M)-receptor blockade (especially chlorpromazine and thioridazine) Hx-receptor blockade (chlorpromazine, thiothixene) t central nervous system (CNS) depression (sedation) t decreased seizure threshold t QT prolongation (thioridazine) Psychiatric schizophrenia (alleviate positive symptoms), bipolar disorder (manic phase) nonpsychiatric antiemesis, preoperative sedation (promethazine) pruritus Oral and parenteral forms, long half-lives with metabolism-dependent elimination Toxicity Extensions of effects on a - and M- receptors blockade of dopamine receptors may result in akathisia, dystonia, parkinsonian symptoms, tardivedyskinesia, and hyperprolactinemia... 

Most theories about the origin of mood disorders refer to the subcellular or molecular level, mainly emphasizing an imbalance between different transmitter systems [17] as a possible cause for unipolar depression as well as bipolar disorders. No concrete concepts exist to explain how and in which way such molecular disturbances modify the neural dynamics and lead to an increased mental vulnerability with progressive occurrence of disease episodes. 

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