Mood Emot 2019 Jul; 17(2): 41-48  
Changes of the Melatonergic System in Bipolar Disorder: A Literature Review
Jung Hyun Lee, MD, PhD1, Eunsoo Moon, MD, PhD2,3
1Department of Psychiatry, Kosin University College of Medicine, 2Department of Psychiatry, Biomedical Research Institute, Pusan National University Hospital, Busan, 3Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Korea
Correspondence to: Eunsoo Moon, MD, PhD
Department of Psychiatry, Pusan National University Hospital, 179 Gudeok-ro, Seo-gu, Busan 49241, Korea
TEL +82-51-240-7303 FAX +82-51-248-3648 E-mail esmun@hanmail.net ORCID https://orcid.org/0000-0002-8863-3413
Received: April 19, 2019; Revised: May 16, 2019; Accepted: May 17, 2019; Published online: July 31, 2019.
© Korean Society for Affective Disorders. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Recently, melatonergic agents have been gaining much interest in the treatment of mood disorders. The elucidation of the underlying biological mechanisms related to the melatonergic system in mood disorders is warranted to ensure the proper use of melatonergic agents. Changes of the melatonergic system have been investigated in several studies of patients with bipolar disorder (BP) and depression. Accumulating evidence has indicated that patients with BP might exhibit abnormal melatonin secretion patterns, increased light-induced melatonin suppression, altered pineal gland volume, genetically abnormal melatonin synthesis enzyme, and modified melatonin receptors. In this review, the findings of studies performed to explore the association between the melatonergic system and BP are discussed. Moreover, the interpretations and limitations of these findings are described.
Keywords: Bipolar disorder; Depression; Melatonin; Melatonin receptor; Pineal gland
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