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How and why do the anticonvulsant work for bipolar?

  1. Mar 21, 2013 #1
    I do not quite understand How and why do the anticonvulsant work for bipolar?

    Can anyone explain this for me in any detail? From what I can see, there are 2 possible ways they work for bipolar.

    1) inhibiting voltage-sensitive sodium channels
    2) Boosting the actions of GABA

    Anyone have a detailed ex[lanation?
  2. jcsd
  3. Mar 23, 2013 #2
    You seem to have a handle on the subject, so I tried to find a recent review article. This article (Jan 2012) should be helpful. Essentially, a number of anticonvulsants qualify as "mood stabilizers" which have proven effective in managing BD, particularly with the manic pole. However, lithium still seems to be the best option for managing the depressive pole (when anti-depressants are not specifically called for) although the anticonvulsant lamotrigine is promising in this regard. Valproate, for example, reduces high frequency action potential firing through the inactivation of voltage gated sodium channels and indirectly enhances GABA. The glutamatergic system is also important and lithium appears to act at CA1 area receptors in the hippocampus, a part of the limbic system which is involved with emotion and mood. Valproate and lamotrigine seem to be involved in the clearance of glutamate.

    As rule lithium would be used together with an anticonvulsant.

    Last edited: Mar 24, 2013
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