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Need exists for genetic predictors of lithium response
  1. James B Potash1,
  2. Thomas G Schulze2
  1. 1Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA;
  2. 2Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August-Universität, Göttingen, Germany

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What is already known on this topic?

Patients with bipolar disorder respond differentially to lithium; some predictors of good response, including a family history of such, are known, though their predictive power is modest.1 As other medications are available for this illness, it would be valuable to identify biomarkers, including genetic ones, with greater ability to accurately forecast which patients will respond to lithium and which will not. One prior study examined genetic biomarkers of response and found no significant results.2

What does this paper add?

  • Genetic variation in one gene almost entirely determined whether patients with bipolar disorder would respond to lithium or not. The results looked remarkably strong, with positive genetic variants increasing the likelihood of response 74-fold. The authors replicated their findings in two additional samples; the results came out similarly both times.

  • The effect, for variants in a gene called glutamate decarboxylase-like 1, was seen in Taiwanese samples. The observed variants are virtually non-existent in European ancestry populations.

Limitations

  • Clinical response to lithium was assessed using the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder developed …

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