Breaking News
June 22, 2018 - Robotic surgery appears to be as effective as open surgery in treating bladder cancer
June 22, 2018 - Many Drugs Made Available Via FDA Expanded Access Programs
June 22, 2018 - Normal eye dominance is not necessary for restoring visual acuity in amblyopia
June 22, 2018 - Parent-Child Interaction Therapy can reduce depression rates in children
June 22, 2018 - Study provides insights into how components of different cells in the brain are altered
June 22, 2018 - Research does not confirm antidiabetic action of natural fatty acid derivatives
June 22, 2018 - Oxidative stress can be used against tumors to treat cancer
June 22, 2018 - Simple, cost-effective test may help improve early diagnosis of mild cognitive impairment
June 22, 2018 - New guide published to help battle fatal disease caused by kissing bugs
June 22, 2018 - Stigma Adds to Burden of Type 1 Diabetes
June 22, 2018 - In retinoblastoma survivors, oculo-visual issues tied to QoL
June 22, 2018 - Most adults with allergies do not use prescribed epinephrine even in emergency situations
June 22, 2018 - Study provides clues to how cancer cells develop resistance to chemotherapies
June 22, 2018 - New consensus paper serves as basis for uniform medical management of DSD
June 22, 2018 - Researchers work to identify areas of the brain that help us wake up
June 22, 2018 - Alcohol hangovers more significant and costly than people realize, shows research
June 22, 2018 - Targeting cells involved in blood vessel formation could hinder brain tumor growth
June 22, 2018 - Young cancer survivors need more support as they feel dissatisfied with their sexuality
June 22, 2018 - Unusual cell-to-cell communication in glioblastoma promotes aggressiveness and therapy resistance
June 22, 2018 - Turning A Phage – Drug Discovery Today
June 22, 2018 - World-first study links birth interventions and long-term childhood illness
June 22, 2018 - Improving the quality of biomedical research samples
June 22, 2018 - Researchers identify cerebral palsy using AI and DNA sequencing
June 22, 2018 - Administering nitric oxide gas after heart surgery may decrease risk of kidney problems
June 22, 2018 - Measuring levels of ethyl sulphate in hair can help assess alcohol consumption
June 22, 2018 - Researchers develop robot bloodhound that can rapidly detect odors on the ground
June 22, 2018 - AAA doses first patients in two clinical studies with PSMA-R2 for prostate cancer
June 22, 2018 - Normalization of ‘plus-size’ body shapes may prevent recognition of health risks of obesity
June 22, 2018 - UC San Diego launches new bacteriophage therapy center
June 22, 2018 - New review outlines current state of sex-sensitive issues linked to heart failure drugs
June 22, 2018 - Pelvic pain a major issue for women nearing mid-life, research reveals
June 22, 2018 - Researchers develop reliable DNA barcodes for biomedical research
June 22, 2018 - New risk-prediction model may help identify diabetic patients at high risk of pancreatic cancer
June 22, 2018 - Study reveals how mTORC1-driven changes in crowding could influence major diseases
June 22, 2018 - Researchers uncover new therapeutic opportunity in the treatment of malignant melanoma
June 22, 2018 - UC Riverside researcher receives grants to advance cancer, ALS research
June 22, 2018 - Radiation therapy alone may be enough to treat older, sicker patients with anal cancers
June 22, 2018 - Technical report describes how to make accurate particle size measurements on carbon black samples
June 22, 2018 - Nocdurna (desmopressin acetate) Approved by FDA as First Sublingual Tablet to Treat Nocturia due to Nocturnal Polyuria
June 22, 2018 - Neuroscientists locate neurons in the brain that respond when a visual target is found
June 22, 2018 - First human Keystone virus infection reported
June 22, 2018 - New study reveals how ‘good’ bacteria help in regulating our metabolism
June 22, 2018 - Osteopathic manual therapy affecting the diaphragm improves chronic low back pain
June 22, 2018 - Researchers create revolutionary model to study pulmonary diseases
June 22, 2018 - Diagnosing Heart Disease Using AI
June 22, 2018 - Increasing biodefense risks posed by synthetic biology
June 22, 2018 - Many Women Report Vasomotor Symptoms in Their 60s
June 22, 2018 - Rare mutation of gene carried by Quebec family gives insight into how the brain is wired
June 22, 2018 - Chemists find new way to make enzymes do a non-natural reaction
June 22, 2018 - Summer is good time to check for signs of skin cancer
June 22, 2018 - Innovative method can help identify patients with spastic cerebral palsy
June 22, 2018 - Exercise alters characteristics of blood to reduce inflammation in obese people
June 22, 2018 - Researchers examine complications across different types of breast reconstructive surgeries
June 22, 2018 - Rhesus macaque model could be useful to test therapies for congenital Zika virus syndrome
June 22, 2018 - AHA: New Insights Into Sickle Cell and Stroke Risk
June 22, 2018 - Doctors prescribe opioids at high rates to those at increased overdose risk
June 22, 2018 - Reduction in US cigarette smoking rates
June 22, 2018 - Preconception binge drinking may have negative effect on future offspring
June 22, 2018 - FDA expands approval of novel diabetes management device to include younger pediatric patients
June 22, 2018 - Researchers confirm weight loss benefits of the 16:8 diet
June 22, 2018 - FDA approves Eversense CGM system for use in adults with diabetes
June 22, 2018 - State opioid monitoring programs are not created equal
June 22, 2018 - Autistic teens who are bullied have higher rates of depression
June 22, 2018 - Penn Medicine team launches universal stroke awareness program
June 22, 2018 - Scientists discover the molecular trigger of necroptosis
June 22, 2018 - Researchers report unusually high levels of herpesvirus in the brains of people with Alzheimer’s disease
June 22, 2018 - Theoretical models predict how juveniles evolve to be more susceptible than adults to infection
June 22, 2018 - USC study reveals how the cell launches emergency response to repair damaged DNA
June 22, 2018 - $1.9 million grant aims to enhance behavioral health services in community-based settings
June 22, 2018 - New 3D imaging technique could improve arthritis treatment
June 22, 2018 - Cytokinetics Announces Data From Phase 2 Clinical Study of Reldesemtiv in Patients With Spinal Muscular Atrophy
June 22, 2018 - Polarized cells give the heart its fully developed form
June 21, 2018 - Stem cells appear to help fight obesity in animal models
June 21, 2018 - Harnessing Pediatric Cancer Genomic Data in the Cloud
June 21, 2018 - Training nursing students with cost-effective 3D-printed task trainers
June 21, 2018 - Study provides insight into how planned and spontaneous movements are processed in the brain
June 21, 2018 - Suicide Prevention | SAMHSA – Substance Abuse and Mental Health Services Administration
June 21, 2018 - From designer microbes to stem cells, researchers are investigating new strategies to treat bowel disease
June 21, 2018 - Study suggests state-of-the-art genomic testing for routine autopsy of stillbirths
June 21, 2018 - Christiana Care Health System opens first Epilepsy Monitoring Unit in Delaware
Gene-based tests may improve treatment for people with bipolar disorder

Gene-based tests may improve treatment for people with bipolar disorder

image_pdfDownload PDFimage_print
Responsiveness to lithium – the gold standard of bipolar treatment – runs in families. Credit: Francisco Gonzalez/unsplash

Bipolar affective disorder (BPAD) affects around 2% of the world’s population, leaving them with bouts of severe depression and episodes of what is commonly referred to as “mania”.

A range of drug treatments are available, but choosing the right medication, or range of medications, can be a struggle – sometimes spanning many years.

But new research aims to shorten this process by matching drug treatments to individual patients, based on their genetic profile.

What is bipolar disorder?

When depressed, people with bipolar have a low mood, poor energy levels, and lose interest in pleasurable activities over the course of many weeks. They also notice ongoing negative thoughts about themselves and their environment.

In the most severe cases, people lose their appetite, are unable to sleep, and have thoughts that circle around death and suicide.

During manic episodes, patients become increasingly unpredictable and engage in activities that are often “out of character”. They might sleep less than usual, spend unreasonable amounts of money (unlike their usual spending patterns), engage in superficial relationships, and start new projects without being really interested in completing them.

As mania progresses, patients can become irritable, impatient, and aggressive towards others. Often they find themselves in conflict with their family or people at work.

In episodes of severe mania, people can develop beliefs that are not in keeping with reality. They might believe they have special powers, or that they are being targeted or threatened by others.

During manic episodes, sufferers typically lose the ability to recognise the changes in their behaviour and thinking, and blame others for their difficulties. They usually also see no reason to seek medical assistance, and can react strongly if others recommend doing so.

Depressive and manic episodes can occur within short periods of time, or after long periods of normal mental health.

Usually, these episodes lead to severe disruptions of a person’s life, and patients are unable to carry out their duties at work and at home. Admissions to psychiatric inpatient units for treatment may be required, sometimes against the patient’s will.

Towards tailored treatments

Most patients with bipolar disorder are prescribed “mood-stabilising” medication for treatment during episodes and to prevent relapse. This usually consists of one, or a combination, of three types of medicine:

lithium saltsanti-epileptic medicines such as sodium valproate, andsome “antipsychotics” such as risperidone, quetiapine, or olanzapine.

It’s hard to predict which drug will work best for each person, so these treatments are generally selected by trial and error.

It can take years until the optimal medication is determined. During this time, patients often experience ongoing mood symptoms, relapses, medication side effects, and reduced functioning.

Psychiatric research labs are now developing tests for personalised drug selection for people with bipolar. The hope is that genetic and blood test information could help determine which drug may work best for a patient, and what should be avoided.

A focus of these research efforts is the mood stabiliser lithium. Lithium is an elementary metal that naturally occurs as a salt, and is seen as the “gold standard” treatment for bipolar. It is useful in treating acute mania, protects against further illness episodes, enhances antidepressant treatments, and can prevent suicidal thoughts and actions.

But only 30% of bipolar patients experience the full range of lithium benefits. For some others, additional medicines have to be added to control the illness. And about 30% of bipolar patients get no benefit at all from lithium, and need to use other types of mood stabilisers.

Responsiveness to lithium can run in families. A patient is more likely to do well on the drug if their parent or sibling (if they also suffer from bipolar disorder) also shows a good response. This suggests a genetic, or heritable, component to the medication response.

Research from our group and others has now begun to untangle the underpinnings of these genetic effects. We found, for example, that bipolar patients who carry many “risk” genes for certain other medical and psychiatric disorders, such as schizophrenia, are less likely to have a good outcome with lithium.

Further, a large-scale genetic study we were involved in found a small number of genes that specifically determine lithium response.

Other studies are starting to uncover the biological effects of these genetic variations. There is increasing evidence, for instance, that people who do well on lithium have specific disturbances in molecular pathways that regulate energy within nerve cells.

These studies suggest people with bipolar illness have a “biological signature” that can predict how they will response to different mood stabilising medicines.

But much work needs to be done, over several years, before these findings can be translated into tests that can be run routinely in psychiatric clinics.


Explore further:
Lithium treatment for bipolar disorder linked to lowest risk of rehospitalisation

Provided by:
The Conversation

Tagged with:

About author

Related Articles