It is well known that there have been no specific treatments for bipolar disorder released since lithium. Any new medications which have been licensed were originally developed for another reason and repurposed.
However one significant development on the horizon is predictive analytics which could be used to predict a mood episode in a patient before it occurs. There is an enormous amount of data that we can harness in very sophisticated ways from smartphones by using a combination of GPS accelerometers, texts, and voice physics. Voice physics is a means of assessing a patient’s psychiatric state through through an analysis of their vocal patterns.
As with many medical specialities, psychiatry and mood disorder treatment will become increasingly focused on harnessing big data. Patient communities like Patients Like Me, patient/practitioner collaborative networks and patient support websites and apps are only a few of the resources now underway. There is the Patient Centered Outcomes Research Institute (PCORI), which is part of the Affordable Care Act, and its associated patient resource, the Patient Centered Outcomes Research Network. PCORI is a patient-powered research network, and it allows patients to choose how they want to be monitored through self-report. The goal of the network which is now live, is to transform the lives of people with mood disorders by a collaboration, to be able to conduct prospective comparative effectiveness research and to serve as an infrastructure for researchers and clinicians. They are focused on collecting clinically useful data, not only from patient-reported outcomes, but also by integrating electronic health networks.
There are other emerging therapeutic apps and websites, including Pacifica, MoodGym, and Now Matters Now, a web site offering help to patients experiencing suicidal thoughts.
At the cutting edge of mood disorder treatments are novel therapies such as transcranial magnetic stimulation. This treatment uses near infrared light, which passes through the skull. Its mechanism is to stabilize mitochondria by stimulating them. When the photon passes through the skull, it stimulates cytochrome C oxidase through the mitochondria, and that increases energy production and also protects neurons.
Low-frequency magnetic stimulation is another innovation that is being investigated. “This technology was discovered when a tech noticed that people coming out of an fMRI machine said they felt a little bit better,” he said. This approach utilizes peroxisome proliferator-activated receptors (PPARs), which act as a switch that essentially regulates DNA in a neuroprotective manner.
No doubt this is just the beginning of the development of more adaptive specific treatments for bipolar and other mood disorders.