Backward Logic and Bipolar

FLASHBACK!!!
Five years ago you would find a 17-year-old version of myself sitting in my high school chemistry room. I felt like the king of the world, I thought I knew everything there was to know about chemistry and the world around me.  In all honesty I thought the noble prize in chemistry just a reward for chemists who found some new use for chemistry. And there is no way I could have been anymore wrong. I think there is more unknown then there is known, and this weeks article on bipolar disorder brings this to light. The Article is titled “Bipolar disorder and the mechanisms of action of mood stabilizers”
This article looks at four different drugs called mood stabilizers that are used to “treat” bipolar disorder. In todays world researchers study chemical pathways of a disorder and decide where they should “attack” the disorder to stop it.  They then create the medicine that does just that! Problem solved. Bipolar is different, over time we have found medication that accomplishes what we want (kind of). These drugs are termed mood stabilizers. The odd thing is we know that these drugs work, we just don’t know how. So the thought is that researchers are going to work backwards. The “cure” is known so we just need to find out what exactly it “cures”.
To quote S. Sobo “How can we argue that we are treating […bipolar disorder…] at a fundamental, etiological level of the illness when we don’t know what the chemical problem is?
So researchers have ideas on how bipolar disorder may happen, but it is still very hypothetical. A few years ago there was a hypotheses called Myo-Inositol Depletion, which was believed to explain bipolar disorder. But in just 5 years researchers have discovered that this hypothesis isn’t probable. This weeks article we read instead focused on the arachidonic acid cascade.
To go into specifics a bit more there are 4 main drugs used to null bipolar symptoms: Lithium, Carbamazepine, Valproic acid, and Lamotrigine. So when we look at a system like the arachidonic acid cascade we try to find how this causes the problem (bi-polar) and then how the drugs prevent this from happening. One way this can be done is by finding specific points in the chemical cascade and finding how drugs affect that point. After all this data is collected we can step back and try to take a holistic view of the disease.
So it can be seen that the arachidonic acid (AA) cascade can cause neuronal damage in quite a few ways. So if we can at what points the drugs stop the AA pathway from proceeding forward we can understand how bipolar disease works. The paper the class was assigned to read actually has a nice spreadsheet breaking down all of the elements of the AA pathway and how the drugs affect these specific elements.  On complication to this process is that some of these drugs help some people but not others, at the same time these drugs have different effects on the specific parts to the pathway. For example all four drugs lower COX-2 levels. Whereas COX-1 levels are only lowered by Sodium valproate, the other drugs having no effect.  Everything is so complicated…
Take home message the body is complicated, and it is even more complicated finding out why things go wrong. Also I think the general public should know that doctors/humans just don’t know everything.