genecrpdResearchers at the University of Michigan have discovered that antipsychotics may work, at least in part, by restoring normal gene function in people with bipolar disorder. (Chen, H., Wang, N., Zhao, X., Ross, C. A., O’Shea, K. S. and McInnis, M. G. (2013), “Gene expression alterations in bipolar disorder postmortem brains.” Bipolar Disorders, 15: 177–187. doi: 10.1111/bdi.12039)

The research team did post-mortem (after death) examinations on the brains of three groups of people:

  • People with bipolar disorder who never took antipsychotics
  • People with bipolar disorder who had taken antipsychotics
  • People without bipolar disorder (the control group)

They looked specifically at the expression of over 2000 unique genes by measuring the proteins that these genes produce. These proteins are involved with the function of the synapses — the gaps between brain cells where communication between the cells occurs. The results:

  • The control brains and the brains exposed to antipsychotics had similar patterns of gene expression (the proteins produced by the genes).
  • The brains of people with bipolar that had not been exposed to antipsychotics had different patterns of protein production.

Until now, we have focused on how medications affect the neurotransmitters, but this research suggests the possibility that what really makes antipsychotic medications effective in treating bipolar may be related to how they affect gene expression. In other words, we know that antipsychotics increase dopamine levels decrease dopamine effects in the brain, but this may be a secondary or even possibly a coincidental effect of changes to gene expression.

This research opens some Interesting possibilities, and I think this kind of study indicates how much the terrain of understanding, diagnosing, and treating mental illness will continue to shift dramatically as the genetic and neurobiology research explodes into the next decades.

Research like this may help in the development of medications that are more effective — targeting specific genes or proteins that are abnormal in bipolar disorder. This kind of specificity in medication may also reduce the risk of side effects by affecting fewer types of cells in the body.

Gene image available from Shutterstock