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.