Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
Department of Neuroscience, Johns Hopkins University, Baltimore, MD 21218, USA.
Int J Mol Sci. 2022 Feb 6;23(3):1844. doi: 10.3390/ijms23031844.
Bipolar disorder (BD) is characterized by mood changes, including recurrent manic, hypomanic, and depressive episodes, which may involve mixed symptoms. Despite the progress in neurobiological research, the pathophysiology of BD has not been extensively described to date. Progress in the understanding of the neurobiology driving BD could help facilitate the discovery of therapeutic targets and biomarkers for its early detection. Oxidative stress (OS), which damages biomolecules and causes mitochondrial and dopamine system dysfunctions, is a persistent finding in patients with BD. Inflammation and immune dysfunction might also play a role in BD pathophysiology. Specific nutrient supplements (nutraceuticals) may target neurobiological pathways suggested to be perturbed in BD, such as inflammation, mitochondrial dysfunction, and OS. Consequently, nutraceuticals may be used in the adjunctive treatment of BD. This paper summarizes the possible roles of OS, mitochondrial dysfunction, and immune system dysregulation in the onset of BD. It then discusses OS-mitigating strategies that may serve as therapeutic interventions for BD. It also analyzes the relationship between diet and BD as well as the use of nutritional interventions in the treatment of BD. In addition, it addresses the use of lithium therapy; novel antipsychotic agents, including clozapine, olanzapine, risperidone, cariprazine, and quetiapine; and anti-inflammatory agents to treat BD. Furthermore, it reviews the efficacy of the most used therapies for BD, such as cognitive-behavioral therapy, bright light therapy, imagery-focused cognitive therapy, and electroconvulsive therapy. A better understanding of the roles of OS, mitochondrial dysfunction, and inflammation in the pathogenesis of bipolar disorder, along with a stronger elucidation of the therapeutic functions of antioxidants, antipsychotics, anti-inflammatory agents, lithium therapy, and light therapies, may lead to improved strategies for the treatment and prevention of bipolar disorder.
双相情感障碍（BD）的特征是情绪变化，包括反复发作的躁狂、轻躁狂和抑郁发作，可能涉及混合症状。尽管神经生物学研究取得了进展，但迄今为止，BD 的病理生理学尚未得到广泛描述。对驱动 BD 的神经生物学的理解进展可能有助于促进治疗靶点和生物标志物的发现，以实现其早期检测。氧化应激（OS）会损害生物分子并导致线粒体和多巴胺系统功能障碍，这是 BD 患者的一个持续发现。炎症和免疫功能障碍也可能在 BD 病理生理学中发挥作用。特定的营养补充剂（营养保健品）可能针对在 BD 中被认为受到干扰的神经生物学途径，例如炎症、线粒体功能障碍和 OS。因此，营养保健品可用于 BD 的辅助治疗。本文总结了 OS、线粒体功能障碍和免疫系统失调在 BD 发病中的可能作用。然后讨论了可能作为 BD 治疗干预的 OS 缓解策略。它还分析了饮食与 BD 的关系以及营养干预在 BD 治疗中的应用。此外，它还涉及锂治疗、新型抗精神病药物，包括氯氮平、奥氮平、利培酮、卡利拉嗪和喹硫平；以及抗炎药物治疗 BD。此外，它还回顾了最常用于 BD 的治疗方法的疗效，例如认知行为疗法、亮光疗法、意象聚焦认知疗法和电惊厥疗法。更好地了解 OS、线粒体功能障碍和炎症在双相情感障碍发病机制中的作用，以及更深入地阐明抗氧化剂、抗精神病药物、抗炎药物、锂治疗和光照疗法的治疗功能，可能会为双相情感障碍的治疗和预防提供更好的策略。
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