Emergent treatments based on the pathophysiology of bipolar disorder: A selective review

• Emergent treatments draw upon advances in our understanding of bipolar disorder.
• Several neuroscience based interventions have entered clinical trials.
• New medications target glutamate, oxidative damage, PKC and hormonal signaling.
• TMS has been evaluated for the treatment of both bipolar depression and depression.
• GWAS studies have led to a novel clinical trial of a calcium channel blocker.

Bipolar disorder is a chronic psychiatric disorder that is a cause of significant symptomatology even in the setting of optimal treatment. Most current treatments are developed from serendipity, and not based on known pathophysiology. In this review we examine a number of somatic and pharmacologic therapies that are poised to become part of the armamentarium of interventions to treat bipolar illness. As a group, these interventions are derived from a growing understanding of the biological underpinnings of bipolar disorders. We will look at emergent treatments based on our understanding of the molecular biology, neuroanatomy, and the genetics of bipolar disorder.