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Genes Determine If Lithium is Effective for Bipolar Disorder

Genes Determine If Lithium is Effective for Bipolar DisorderLithium is one of the most effective drugs for treating bipolar disorder, but not everyone’s symptoms are relieved.   

New research shows that a patient’s response to the drug is based on a gene-level reaction, especially in the triggering or repression of genes which affect the levels of cell death (known as apoptosis).

For example, the gene called BCL2 — known to play an important role in the therapeutic effects of lithium — did not increase in non-responders. This can be measured in the blood of patients within four weeks of treatment.

For the study, researchers from Yale University School of Medicine measured the changing levels of gene activity in the blood of 20 depressed adult participants with bipolar disorder before treatment, and then again every 14 days once treatment with lithium had begun.

Throughout the eight weeks of treatment there were significant differences in the levels of gene expression between those who responded to lithium (measured using the Hamilton Depression Rating Scale) and those who did not respond.

“We found 127 genes that had different patterns of activity (turned up or down) and the most affected cellular signaling pathway was that controlled programmed cell death (apoptosis),” said reearcher Dr. Robert Beech.

For bipolar patients who responded to lithium, the genes which protect against cell death (including Bcl2 and IRS2) were increased, while those which promote cell death were decreased, including the genes known as BAD and BAK1.

“This positive swing in regulation of apoptosis for lithium responders was measurable as early as four weeks after the start of treatment, while in non-responders there was a measureable shift in the opposite direction. It seems then, that increased expression of BCL2 and related genes is necessary for the therapeutic effects of lithium,” said Beech.

“Understanding these differences in genes expression may lead towards personalized treatment for bipolar disorder in the future.”

Source:  Biology of Mood & Anxiety Disorders

Abstract DNA photo by shutterstock.

Genes Determine If Lithium is Effective for Bipolar Disorder

Traci Pedersen

Traci Pedersen is a professional writer with over a decade of experience. Her work consists of writing for both print and online publishers in a variety of genres including science chapter books, college and career articles, and elementary school curriculum.

APA Reference
Pedersen, T. (2018). Genes Determine If Lithium is Effective for Bipolar Disorder. Psych Central. Retrieved on April 19, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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