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Its mechanism involves modulation of the hypothalamic-pituitary-adrenal (HPA) axis, regulation of cortisol and growth hormone-releasing hormone (GHRH) secretion, and interaction with the GABAergic and glutamatergic systems

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Recent enzymatic analyses in lymphocytes showed that BD patients in the depressive phase had lower levels of mitochondrial complex II activity compared to those in the euthymic phase, with a significant negative correlation between the Hamilton Depression Rating Scale score and mitochondrial complex II activity [50], providing a strong link between reduced mitochondrial function and current bipolar depressive phase