Current Treatment Options in Psychiatry

, Volume 5, Issue 1, pp 162–181 | Cite as

Novel Therapeutics in Bipolar Disorder

  • Sabrina C. da Costa
  • Rodrigo Machado-Vieira
  • Jair C. Soares
Bipolar and Other Mood Disorders (B Goldstein and D Hafeman, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Bipolar and Other Mood Disorders

Opinion statement

Recent findings

Existing pharmacological treatments for bipolar disorder have demonstrated insufficient efficacy, delayed onset of action, and significant side effects. Emerging evidence suggest that rapid antidepressant activity can be achieved in humans, and findings from the use of glutamatergic and anticholinergic drugs, for instance, reveal promising results.

Purpose of review

In the present article, we review evidence supporting the use of novel therapies in bipolar disorder, with focus on drugs acting in the glutamatergic system. In addition, anticholinergic drugs, melatonergic agonists, glucocorticoid modulators, and mechanistically diverse anti-inflammatory agents will be briefly discussed.


While preliminary findings on novel therapies for bipolar disorder are encouraging, current evidence is still insufficient to support extensive use of these drugs routinely. Long-term safety, tolerability, and efficacy remain unclear; several clinical trials are underway and may add clarity to these questions. Early detection and prompt intervention have the potential to decelerate illness progression and lessen the burden associated with bipolar disorder; thus, novel therapies with rapid and sustained clinical benefits are urgent.


Bipolar disorder Glutamatergic system Cholinergic system Melatonergic system HPA-axis Immune dysregulation and oxidative stress 


Compliance with ethical standards

Conflicts of Interest

Sabrina C. da Costa, Rodrigo Machado-Vieira, and Jair C. Soares declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article is a review paper. Although it alludes to clinical and preclinical work, it does not contain any studies with human or animal subjects performed by any of the authors in this section.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance: Compelling evidence from clinical trials, systematic reviews and meta-analyses.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018
corrected publication March/2018

Authors and Affiliations

  • Sabrina C. da Costa
    • 1
  • Rodrigo Machado-Vieira
    • 1
  • Jair C. Soares
    • 1
  1. 1.Department of Psychiatry and Behavioral Sciences, McGovern Medical SchoolUniversity of Texas Health Science Center at HoustonHoustonUSA

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