New data suggests that individual differences in the treatment response to lithium in patients with bipolar disorder may occur at the genetic level. The researchers identified a number of gene-expression changes that were specific to patients who responded favorably to lithium.
The study compared gene-expression changes in patients who responded favorably to treatment with lithium to those who failed to respond to lithium as well as patients with bipolar disorder who were treated with other medications.
The genes involved were related to a number of mechanisms previously implicated in the therapeutic actions of lithium, including regulation of autophagy, neurite outgrowth and mitochondrially mediated apoptosis.
The changes could be clinically useful in decisions regarding the effectiveness of lithium as a treatment for patients with bipolar disorder, including whether to continue or discontinue the treatment.
Robert Beech, MD, PhD, assistant professor of psychiatry at Yale School of Medicine, is the lead author of the current study. Dr. Beech presented the new findings at the Society for Biological Psychiatry's 2013 Annual Meeting in San Francisco, California.
The findings appear in The Pharmacogenomics Journal and confirm some of the results of a smaller study done at Yale that was published last year (Lowthert et al., 2012).
The study is part of a large multi-site clinical trial for patients with bipolar disorder (LiTMUS) involving researchers at Yale, Harvard/Mass General Hospital, University of Texas Health Science Center at San Antonio, Case Western Reserve University, University of Pittsburgh Medical Center, Stanford, Mount Sinai Medical Center, and University of Pennsylvania.
The work was supported by grants from the California Bipolar Foundation and The Patrick and Catherine Weldon Donaghue Medical Research Foundation.