Recurrence as the Rule: BD Symptoms Persist and Cycle

Faculty: Jose M. Rubio, MD, PhD


Faculty: Sunny X. Tang, MD

In this MinuteCE, Drs. Jose Rubio and Sunny Tang examine the recurrent course of bipolar disorder, predictors of relapse, and the clinical burden of residual mood symptoms and cognitive impairment. They discuss limitations of current pharmacologic therapies and review dopaminergic and cholinergic neurocircuitry, with emphasis on M1 and M4 muscarinic receptors as potential therapeutic targets for mania, psychosis, and cognitive dysfunction. The discussion also examines ongoing phase 3 BALSAM-1 and BALSAM-2 trials of xanomeline-trospium for acute mania and mania with mixed features, as well as its potential role in the bipolar disorder treatment algorithm.