Recent progress in the pharmacotherapy of bipolar disorder

Abstract

Bipolar disorder is a common and highly disabling condition necessitating early and effective therapeutic intervention. This review focuses on recent progress in pharmacotherapies reported in the last few years. The recent literature suggests two distinct developmental themes. The first is the consolidation of knowledge concerning the role of the atypical antipsychotics and anticonvulsants in bipolar disorder, with increasing clarity regarding which actions are ‘class effects’ and which actions are, in contrast, specific to particular agents. The second theme is the first ‘glimmerings’ of the mood stabilizing efficacy of compounds with ‘novel’ actions, with tamoxifen being perhaps the agent of most interest. While demonstration of the efficacy of truly innovative compounds developed specifically for bipolar disorder has yet to occur, the gradual understanding of some of the critical pharmacological mechanisms of action of current agents suggests that this may not be too distant a reality.