Mood stabilizers and ion regulation.

Understanding the pathogenesis and pathophysiology of bipolar disorder is a prerequisite for accelerating the development of effective therapeutic agents and interventions. One of the best clues to these processes lies in shared mechanisms of action of mood-stabilizing agents. All effective mood stabilizers share the ability to attenuate the influx and intracellular accumulation of sodium in an activity-dependent manner. When coupled with independent observations of aberrant ion regulation in mania and bipolar depression, this shared characteristic is potentially significant. A unified hypothesis is presented in which lithium, valproic acid, and carbamazepine are suggested to produce antimanic effects by modifying ion flux and intracellular ion concentrations.