The circadian system of patients with bipolar disorder differs in episodes of mania and depression

During episodes of mania, melatonin levels are elevated during the daytime in patients with bipolar disorder compared to healthy controls and patients in depressive episodes.

• Melatonin profiles show significant differences between patients in mania and those in depression.
• No differences in melatonin profiles were observed between healthy controls and patients in depression.
• The expression profiles of the Per1 and Nr1d1 clock genes are advanced in patients experiencing mania compared to those in depression.
• A trend toward an advance in circadian profiles was noted in patients during manic episodes when compared to controls, but not in depression.
• The amplitude of the Nr1d1 expression was higher in patients experiencing mania than in those with depression.

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