Can the response to mood stabilizers be predicted in bipolar disorder?

Front Biosci (Elite Ed). 2014 Jan 1;6(1):120-38. doi: 10.2741/e696.

Abstract

Bipolar disorder (BD) is a severe chronic multifactorial disease that requires maintenance therapy with mood stabilizers (MS). Even with medications, the rate of response among patients with BD is low and the risk of relapse is high. Therefore, in this context of the urgent need for reliable and reproducible predictors of individual responses to MS, pharmacogenetics research is expected to provide helpful progress. Most pharmacogenetic studies of MS have focused on the response to lithium with several good putative candidate genes but informative results are sparse. There have been few studies on valproate, lamotrigine or atypical antipsychotics. Overall, the results of pharmacogenomics studies have not provided sufficient data to change daily practices in BD significantly and further investigation is warranted to identify highly relevant genetic predictors of response their roles. Although progress still remains to be made, the clinical assessment of a subject including the identification of specific individual phenotypic and pharmacogenetic characteristics is likely to become a powerful instrument for the development of personalized therapies.

Publication types

  • Review

MeSH terms

  • Antimanic Agents / therapeutic use*
  • Bipolar Disorder / diagnosis*
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / genetics
  • Circadian Rhythm Signaling Peptides and Proteins / metabolism*
  • Genetic Association Studies / methods
  • Genome-Wide Association Study
  • Humans
  • Inositol
  • Lithium
  • Neurotransmitter Agents / metabolism*
  • Pharmacogenetics / methods*
  • Phenotype*
  • Valproic Acid

Substances

  • Antimanic Agents
  • Circadian Rhythm Signaling Peptides and Proteins
  • Neurotransmitter Agents
  • Inositol
  • Valproic Acid
  • Lithium