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Dopamine dysregulation syndrome : implications for a dopamine hypothesis of bipolar disorder
journal contribution
posted on 2007-10-01, 00:00 authored by Michael BerkMichael Berk, Seetal DoddSeetal Dodd, M Kauer-Sant'Anna, G Malhi, M Bourin, F Kapczinski, T NormanObjective: Rational therapeutic development in bipolar is hampered by a lack of pathophysiological model. However, there is a wealth of converging data on the role of dopamine in bipolar disorder. This paper therefore examines the possibility of a dopamine hypothesis for bipolar disorder.
Method:A literature search was conducted using standard search engines Embase, PyschLIT, PubMed and MEDLINE. In addition, papers and book chapters known to the authors were retrieved and examined for further relevant articles.
Results: Collectively, in excess of 100 articles were reviewed from which approximately 75% were relevant to the focus of this paper.
Conclusion: Pharmacological models suggest a role of increased dopaminergic drive in mania and the converse in depression. In Parkinson’s disease, administration of high-dose dopamine precursors can produce a ‘maniform’ picture, which switches into a depressive analogue on withdrawal. It is possible that in bipolar disorder there is a cyclical process, where increased dopaminergic transmission in mania leads to a secondary down regulation of dopaminergic receptor sensitivity over time. This may lead to a period of decreased dopaminergic transmission, corresponding with the depressive phase, and the repetition of the cycle. This model, if verified, may have implications for rational drug development.
Method:A literature search was conducted using standard search engines Embase, PyschLIT, PubMed and MEDLINE. In addition, papers and book chapters known to the authors were retrieved and examined for further relevant articles.
Results: Collectively, in excess of 100 articles were reviewed from which approximately 75% were relevant to the focus of this paper.
Conclusion: Pharmacological models suggest a role of increased dopaminergic drive in mania and the converse in depression. In Parkinson’s disease, administration of high-dose dopamine precursors can produce a ‘maniform’ picture, which switches into a depressive analogue on withdrawal. It is possible that in bipolar disorder there is a cyclical process, where increased dopaminergic transmission in mania leads to a secondary down regulation of dopaminergic receptor sensitivity over time. This may lead to a period of decreased dopaminergic transmission, corresponding with the depressive phase, and the repetition of the cycle. This model, if verified, may have implications for rational drug development.
History
Journal
Acta Psychiatrica ScandinavicaVolume
116Issue
s434Season
SupplementPagination
41 - 49Publisher
Wiley-Blackwell PublishingLocation
Hoboken, N.J.Publisher DOI
ISSN
0001-690XeISSN
1600-0447Language
engPublication classification
C1.1 Refereed article in a scholarly journalCopyright notice
2007, The AuthorsUsage metrics
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