Table 1.

Effective anti-bipolar agents downregulate parts of the rat brain arachidonic acid cascade

Treatment	AA turnover	DHA turnover	cPLA2 mRNA, protein, activityf	sPLA2 mRNA, protein, activity	iPLA2 mRNA, protein, activity	AA-selective acyl-CoA synthetase activity	COX-2 protein and/or activity	PGE2e
Lithiuma	↓	Nc	↓	Nc	Nc	Nc	↓	↓
Carbamazepinea	↓	Nc	↓	Nc	Nc	Nc	↓	↓
Valproatea	↓	Nc	Nc	Nc	Nc	↓	↓ +mRNAd	↓
Lamotrigineb	Nc	-	Nc	Nc	Nc	-	↓ +mRNA	-
Topiramatec	Nc	Nc	Nc	Nc	Nc	-	Nc	Nc

Nc, no change; -, not tested.

^aPreferred for bipolar mania.

^bPreferred for bipolar depression.

^cIneffective in phase III trials.

^dCOX-1 mRNA and TXB₂ also decreased; accompanied by reduced binding NF- κB.

^eFormed preferentially via COX-2.

^fAccompanied by reduced binding of AP-2.