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The Emerging Differential Roles of GABAergic and Antiglutamatergic Agents in Bipolar Disorders.

Terence A. Ketter, MD, and Po W. Wang, MD

Published: March 1, 2003

Article Abstract

Treatment options to relieve the diverse symptoms encountered in patients with bipolar disordersinclude not only mood stabilizers, but also anxiolytics, new anticonvulsants, antidepressants, and antipsychotics.These agents have widely varying mechanisms of action, which could contribute to theheterogeneity of clinical effects seen in practice. Several of these medications, especially those withanticonvulsant effects, enhance γ-aminobutyric acid (GABA) inhibitory neurotransmission and/orattenuate glutamate excitatory neurotransmission. We review the efficacy and tolerability of these diversetreatment options in bipolar disorders and explore possible relationships between clinical effectsand GABAergic and antiglutamatergic mechanisms of action.

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