ABSTRACT
Bipolar disorder is a common, severe, recurring and, often, chronic disease marked by episodes of hypomania, mania and or depression. Although the course can be episodic with intervening periods of euthymia, chronic subthreshold mood symptoms can commonly result in dysfunction in a variety of domains in patients’ lives. It is also associated with high rates of mortality, both because of suicide and increased risk of medical illnesses like cardiovascular disease. The data are substantial that if the illness is not treated or if it is inadequately treated, there is a tendency for accelerated cycling and shorter intervals of wellness between episodes (reviewed in Post, 2007b). Consequently, the outcome is associated with high rates of relapse, chronicity, residual symptoms, comorbidities, cognitive and functional impairment, and psychosocial disability. Few current treatments have bimodal efficacy and most have undesirable side effects. The need for discovering new therapeutic agents that are both efficacious and have fewer side effects is, therefore, compelling.
