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Expert Opin Ther Targets. 2015 Jun;19(6):747-63. doi: 10.1517/14728222.2015.1018822. Epub 2015 Mar 2.

Sleep- and circadian rhythm-associated pathways as therapeutic targets in bipolar disorder.

Author information

1
Inserm, U1144 , Paris, F-75006 , France.

Abstract

INTRODUCTION:

Disruptions in sleep and circadian rhythms are observed in individuals with bipolar disorders (BD), both during acute mood episodes and remission. Such abnormalities may relate to dysfunction of the molecular circadian clock and could offer a target for new drugs.

AREAS COVERED:

This review focuses on clinical, actigraphic, biochemical and genetic biomarkers of BDs, as well as animal and cellular models, and highlights that sleep and circadian rhythm disturbances are closely linked to the susceptibility to BDs and vulnerability to mood relapses. As lithium is likely to act as a synchronizer and stabilizer of circadian rhythms, we will review pharmacogenetic studies testing circadian gene polymorphisms and prophylactic response to lithium. Interventions such as sleep deprivation, light therapy and psychological therapies may also target sleep and circadian disruptions in BDs efficiently for treatment and prevention of bipolar depression.

EXPERT OPINION:

We suggest that future research should clarify the associations between sleep and circadian rhythm disturbances and alterations of the molecular clock in order to identify critical targets within the circadian pathway. The investigation of such targets using human cellular models or animal models combined with 'omics' approaches are crucial steps for new drug development.

KEYWORDS:

bipolar disorders; circadian rhythm; sleep; therapeutic response

PMID:
25726988
DOI:
10.1517/14728222.2015.1018822
[Indexed for MEDLINE]

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