The role of valproate in metabolic disturbances in bipolar disorder patients

Chang, Hui Hua; Yang, Yen Kuang; Gean, Po Wu; Huang, Hui Chun; Chen, Po See; Lu, Ru Band

doi:10.1016/j.jad.2009.12.011

Cited by 55 publications

(43 citation statements)

References 53 publications

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“…We should keep in mind that pharmacotherapy has potential risks for poor clinical metabolic profiles. Among commonly used mood stabilizers, valproate had reproductive endocrine effects on polycystic ovary syndrome and increased the risk of metabolic disturbance through elevated insulin, triglyceride, body mass index and lower HDL levels by interfering with brain glucose transport [39]. Antipsychotics, especially some second-generation antipsychotics, are proposed as monotherapy or add-on pharmacotherapy for bipolar disorder.…”

Section: Discussionmentioning

confidence: 99%

Increased risk of hyperlipidemia in patients with bipolar disorder: a population-based study

Hsu

Chien

Lin

2015

General Hospital Psychiatry

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Section: Discussionmentioning

confidence: 99%

Increased risk of hyperlipidemia in patients with bipolar disorder: a population-based study

Hsu

Chien

Lin

2015

General Hospital Psychiatry

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“…Further, the chronic use of VPA also results in visceral weight gain, because it is still used in patients suffering from epilepsy (36,42,43) or having manic episodes during bipolar disorders (44). We have shown that one of the mechanisms by which glucocorticoids mediate this effect is through the up-regulation of C/ebp␣ via direct transcriptional activation of the promoter and regulation of the transcriptional activity of C/EBP␤ (13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Inactivation of Histone Deacetylase 1 (HDAC1) But Not HDAC2 Is Required for the Glucocorticoid-Dependent CCAAT/Enhancer-Binding Protein α (C/EBPα) Expression and Preadipocyte Differentiation

Kuzmochka¹,

Abdou

Haché

et al. 2014

Endocrinology

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Several drugs currently used in the management of mood disorders, epilepsy (ie, valproic acid), or the control of inflammation (ie, corticosteroids) have been shown to promote visceral obesity in humans by increasing the number of newly formed adipocytes. Valproic acid is classified as a nonspecific histone deacetylase (HDAC) inhibitor, along with trichostatin A and butyric acid. In vitro experiments have demonstrated that such molecules greatly enhance the rate of preadipocyte differentiation, similarly to the effect of corticosteroids. The glucocorticoid receptor stimulates adipogenesis in part by enhancing the transcription of C/ebpa through the titration, and subsequent degradation, of HDAC1 from the C/ebpα promoter. There is, however, controversy in the literature as to the role of HDACs during adipogenesis. In this study, we sought to demonstrate, using 2 different strategies, the definite role of HDAC1 in adipogenesis. By using small interference RNA-mediated knockdown of HDAC1 and by generating an enzymatically inactive HDAC1D181A by site-directed mutagenesis, we were able to show that HDAC1, but not HDAC2, suppresses glucocorticoid receptor-potentiated preadipocyte differentiation by decreasing CCAAT/enhancer-binding protein (C/ebp)α and Pparγ expression levels at the onset of differentiation. Finally, we demonstrate that HDAC1D181A acts as a dominant negative mutant of HDAC1 during adipogenesis by modulating C/EBPβ transcriptional activity on the C/ebpα promoter.

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“…In a cohort study, divalproex was associated with significantly higher plasma insulin, triglyceride levels, and BMI, as well as lower fasting glucose and high-density lipoprotein cholesterol (HDL-C) levels (377).…”

Section: Safety and Tolerability Of Pharmacotherapy For Bdmentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

et al. 2012

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Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, O’Donovan C, MacQueen G, McIntyre RS, Sharma V, Ravindran A, Young LT, Milev R, Bond DJ, Frey BN, Goldstein BI, Lafer B, Birmaher B, Ha K, Nolen WA, Berk M.  Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013.  Bipolar Disord 2012: 00: 000–000. © 2012 John Wiley & Sons A/S.Published by Blackwell Publishing Ltd.The Canadian Network for Mood and Anxiety Treatments published guidelines for the management of bipolar disorder in 2005, with updates in 2007 and 2009. This third update, in conjunction with the International Society for Bipolar Disorders, reviews new evidence and is designed to be used in conjunction with the previous publications.The recommendations for the management of acute mania remain largely unchanged. Lithium, valproate, and several atypical antipsychotic agents continue to be first‐line treatments for acute mania. Monotherapy with asenapine, paliperidone extended release (ER), and divalproex ER, as well as adjunctive asenapine, have been added as first‐line options.For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, as well as olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first‐line options. Lurasidone monotherapy and the combination of lurasidone or lamotrigine plus lithium or divalproex have been added as a second‐line options. Ziprasidone alone or as adjunctive therapy, and adjunctive levetiracetam have been added as not‐recommended options for the treatment of bipolar depression. Lithium, lamotrigine, valproate, olanzapine, quetiapine, aripiprazole, risperidone long‐acting injection, and adjunctive ziprasidone continue to be first‐line options for maintenance treatment of bipolar disorder. Asenapine alone or as adjunctive therapy have been added as third‐line options.

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The role of valproate in metabolic disturbances in bipolar disorder patients

Cited by 55 publications

References 53 publications

Increased risk of hyperlipidemia in patients with bipolar disorder: a population-based study

Increased risk of hyperlipidemia in patients with bipolar disorder: a population-based study

Inactivation of Histone Deacetylase 1 (HDAC1) But Not HDAC2 Is Required for the Glucocorticoid-Dependent CCAAT/Enhancer-Binding Protein α (C/EBPα) Expression and Preadipocyte Differentiation

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013

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