Serotonin in mania and in the mechanism of action of mood stabilizers: a review of clinical studies

Abstract

There is some evidence from clinical studies for the contribution of 5-HT in mania and in the mechanism of action of mood stabilizers. However, it is very likely that other neurotransmitters also play important roles. Future directions for research include 1) in vivo study of 5-HT receptor subtypes using positron emission tomography, 2) investigation of the interaction between 5-HT and other neurotransmitter systems, and 3) determination of the relationships between diagnostic subtypes of mania and 5-HT function and other neurotransmitter systems.

Convergent Effects of Lithium and Valproate on the Expression of Proteins Associated with Large Dense Core Vesicles in NGF-differentiated PC12 Cells

“…Although it remains to be established whether the reported changes of LDCV protein expression contribute mechanistically to this change in the regulated secretory behavior of these cells, there is ample evidence from other groups that lithium alters the content and secretion of monoamines and selected neuropeptides, which are stored in and released from LDCV (Hesketh et al, 1978;Treiser et al, 1981;Staunton et al, 1982;Ebstein et al, 1983;Hong et al, 1983;Mitsushio et al, 1988;Sivam et al, 1988Sivam et al, , 1989Mathé et al, 1990;Husum et al, 2000;Shiah and Yatham, 2000). And, as observed in the current experiments, in the majority of these cited examples, the effect of lithium was to increase the content or secretion of the neurotransmitter or neuromodulator.…”

Platelet serotonin and serum lipids in psychotic mania

“…Serotonergic system might be involved in the pathophysiology of bipolar disorder (Shiah and Yatham, 2000;Mahmood and Silverstone, 2001;Shastry, 2005). A few studies investigated serotonin (5-hydroxytryptamine, 5-HT) levels (Takahashi, 1976;Saxena et al, 1999), monoamine oxidase (MAO) activity (Takahashi, 1977) and 5-HT2A receptors (Pandey et al, 2003) in manic patients using blood platelets as a peripheral model for the central serotonergic neurons (Plain and Berk, 2001).…”

Old drug, new data

“…Preclinical and clinical studies suggest that, in the short term, lithium can increase serotonergic neurotransmission (Price et al, 1990;Shiah & Yatham, 2000). However, this effect is not always evident after long-term treatment and therefore the implications of this in the mechanism of action of lithium in longterm treatment and in its anti-suicide effect are unclear (Lenox & Manji, 1995).…”