Abstract
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. 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.
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