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    Mitochondrial Agents for Bipolar Disorder

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    Author
    Pereira, C; Chavarria, V; Vian, J; Ashton, MM; Berk, M; Marx, W; Dean, OM
    Date
    2018-06-01
    Source Title
    International Journal of Neuropsychopharmacology
    Publisher
    OXFORD UNIV PRESS
    University of Melbourne Author/s
    Ashton, Melanie; Dean, Olivia; Berk, Michael
    Affiliation
    Psychiatry
    Metadata
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    Document Type
    Journal Article
    Citations
    Pereira, C., Chavarria, V., Vian, J., Ashton, M. M., Berk, M., Marx, W. & Dean, O. M. (2018). Mitochondrial Agents for Bipolar Disorder. INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY, 21 (6), pp.550-569. https://doi.org/10.1093/ijnp/pyy018.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253500
    DOI
    10.1093/ijnp/pyy018
    Abstract
    Background: Bipolar disorder is a chronic and often debilitating illness. Current treatment options (both pharmaco- and psychotherapy) have shown efficacy, but for many leave a shortfall in recovery. Advances in the understanding of the pathophysiology of bipolar disorder suggest that interventions that target mitochondrial dysfunction may provide a therapeutic benefit. Methods: This review explores the current and growing theoretical rationale as well as existing preclinical and clinical data for those therapies aiming to target the mitochondrion in bipolar disorder. A Clinicaltrials.gov and ANZCTR search was conducted for complete and ongoing trials on mitochondrial agents used in psychiatric disorders. A PubMed search was also conducted for literature published between January 1981 and July 2017. Systematic reviews, randomized controlled trials, observational studies, case series, and animal studies with an emphasis on agents affecting mitochondrial function and its role in bipolar disorder were included. The search was augmented by manually searching the references of key papers and related literature. The results were presented as a narrative review. Results: Mitochondrial agents offer new horizons in mood disorder treatment. While some negative effects have been reported, most compounds are overall well tolerated and have generally benign side-effect profiles. Conclusions: The study of neuroinflammation, neurodegeneration, and mitochondrial function has contributed the understanding of bipolar disorder's pathophysiology. Agents targeting these pathways could be a potential therapeutic strategy. Future directions include identification of novel candidate mitochondrial modulators as well as rigorous and well-powered clinical trials.

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