Mood stabilizers and ion regulation

Understanding the pathogenesis and pathophysiology of bipolar disorder is a prerequisite for accelerating the development of effective therapeutic age nts and interventions. One of the best clues to these processes lies in sha red mechanisms of action of mood-stabilizing agents. All effective mood sta bilizers share the ability to attenuate the influx and intracellular accumu lation of sodium in an activity-dependent manner. When coupled with indepen dent observations of aberrant ion regulation in mania and bipolar depressio n, this shared characteristic is potentially significant. A unified hypothe sis is presented in which lithium. valproic acid, and carbamazepine are sug gested to produce antimanic effects by modifying ion flux and intracellular ion concentrations.