Breaking News
March 19, 2019 - Scientists reverse alcohol-seeking behavior in rats with flip of a switch
March 19, 2019 - Researchers hope blood test that accurately diagnoses fibromyalgia could be available within five years
March 19, 2019 - New Planmeca ProScanner 2.0 offers fast and dependable intraoral imaging
March 19, 2019 - A new option for reducing LDL cholesterol in patients at high risk for heart attack, stroke
March 19, 2019 - Common medications to treat heartburn linked to increased risks for kidney failure
March 19, 2019 - Current HBV genome sequences help deduce ancient human population movements into Australia
March 19, 2019 - Pure omega-3 prescription drug significantly reduces the occurrence of ischemic events
March 19, 2019 - Researchers use big data to gain better understanding of hepatitis E virus
March 19, 2019 - Use of synthetic psychedelic linked to improvements in depression and anxiety
March 19, 2019 - Knee Pain Not Tied to Activity Levels in Knee Osteoarthritis
March 19, 2019 - Study shows benefits of delayed cord clamping in healthy babies
March 19, 2019 - Pharmacists can undertake overall clinical responsibility for patients, shows study
March 19, 2019 - A cell’s “self-destruct” function could yield new therapies
March 19, 2019 - Latest advances and perspectives of all AI types used in pharmaceutical R&D
March 19, 2019 - Prophylactic cranial irradiation used as standard approach for patients with NSCLC
March 19, 2019 - Sugar-sweetened beverages may be linked with increased risk of cardiovascular mortality
March 19, 2019 - AHA News: Black Woman in Their 50s Face Especially High Stroke Risk
March 19, 2019 - Secrets of early life revealed from less than half a teaspoon of blood
March 19, 2019 - Immune cells engineered to tattle on suspicious cells in the body
March 19, 2019 - Heart attack patients who are taken to heart care centres directly survive longer
March 19, 2019 - IVF babies have increased in birthweight over the past 25 years, study reveals
March 19, 2019 - Study highlights the need for psychiatric care to be integrated into cancer treatment
March 19, 2019 - Testosterone treatment lowers recurrence rates in low-risk prostate cancer patients
March 19, 2019 - Caterpillars could hold the secret to new treatment for Osteoarthritis
March 19, 2019 - Parkinson’s treatment delivers a power-up to brain cell ‘batteries’
March 19, 2019 - Stanford launches new Institute for Human-Centered Artificial Intelligence
March 19, 2019 - Wireless earphones may cause cancer
March 18, 2019 - ACC/AHA guideline for prevention of cardiovascular disease released
March 18, 2019 - UTA nursing professor receives $6.575 million to attack musculoskeletal diseases
March 18, 2019 - Gene medication shows promise to treat spinal cord injuries
March 18, 2019 - First Human Study of “Robotic” RaniPill™ Capsule to Replace Injections Announced by Rani Therapeutics
March 18, 2019 - Food Allergy Testing: MedlinePlus Lab Test Information
March 18, 2019 - Altered brain activity patterns of Parkinson’s captured in mice
March 18, 2019 - Apple Heart Study demonstrates ability of wearable technology to detect atrial fibrillation | News Center
March 18, 2019 - Cardiovascular benefits of diabetes drug extend across a wide spectrum of patients, shows study
March 18, 2019 - Novel cardiac pump shows superior outcomes in patients with advanced heart failure
March 18, 2019 - U.S. FDA Grants Priority Review for Fedratinib New Drug Application in Myelofibrosis
March 18, 2019 - Living like a caveman won’t make you thin—but it might make you healthy
March 18, 2019 - Modified immune cells issue alert when detecting cancer in mice | News Center
March 18, 2019 - Dementia caregivers design robots for alleviating stress and increasing joyful moments
March 18, 2019 - VR technology could help improve balance in humans
March 18, 2019 - Study demonstrates effective way to slow progression of cerebrovascular disease in older adults
March 18, 2019 - Premature babies also have protective anti-viral antibodies
March 18, 2019 - Painkillers taken by pregnant mothers unlikely to cause asthma in the child
March 18, 2019 - Fibromyalgia can be reliably detected in blood samples
March 18, 2019 - Marijuana use has dropped among most teens after legalization
March 18, 2019 - Legacy Pharmaceutical Packaging, LLC Issues Voluntary Nationwide Recall of Losartan Potassium Tablets, USP, 25mg, 50mg, And 100mg Due to The Detection of Trace Amounts Of N-Nitroso N-Methyl 4-Amino Butyric Acid (NMBA) Impurity Found in The Active Pharmaceutical Ingredient (API)
March 18, 2019 - Researchers identify early home and family factors that contribute to obesity
March 18, 2019 - Fate and festivity: Match Day 2019
March 18, 2019 - Study finds TAVR to be as good as open-heart surgery for patients at low surgical risk
March 18, 2019 - EU-funded project is developing new tools for diagnosing cancer
March 18, 2019 - Gluten, lactose, food dyes in pills could be causing side effects finds study
March 18, 2019 - Taking painkillers during pregnancy is not responsible for asthma risk in children, study shows
March 18, 2019 - Prediagnosis Psychiatric Care Linked to Worse Cancer Mortality
March 18, 2019 - Paris hospital halts stool study after donor deluge
March 18, 2019 - Partial oral antibiotic therapy shows efficacy and safety in patients with infectious endocarditis
March 18, 2019 - Olympus improves access to science education through BioBus collaboration
March 18, 2019 - Depression screening does not improve quality of life in heart attack patients
March 18, 2019 - Echocardiography may aid in patient selection for TMVR
March 18, 2019 - Are ‘Inactive’ Ingredients in Your Drugs Really So Harmless?
March 18, 2019 - Wearable technology can safely identify atrial fibrillation
March 18, 2019 - Scientists tackle rare retinal disease in unique research project
March 18, 2019 - Death By A Thousand Clicks
March 18, 2019 - Absorbable, antibiotic-eluting envelope can reduce rate of cardiac device infections
March 18, 2019 - Hormonal treatment associated with depression in men with prostate cancer
March 18, 2019 - Porvair Sciences launches reinforced 96-well deep round microplate
March 18, 2019 - Simplified catheter ablation could slash waiting lists for atrial fibrillation patients
March 18, 2019 - BFR therapy as part of rehabilitation following ACL surgery may slow bone loss
March 18, 2019 - A human model to test implants for cataract surgery
March 18, 2019 - New risk adjustment model could reduce financial penalty for safety net hospitals
March 18, 2019 - NHS cancer patients’ wait to start treatment worrying
March 18, 2019 - Inventiva Announces Results from Phase IIb Clinical Trial with Lanifibranor in Systemic Sclerosis
March 18, 2019 - Cologuard
March 18, 2019 - Researchers find evidence of prenatal environment tuning genomic imprinting
March 18, 2019 - Dolomite Bio launches novel Nadia product family for single-cell research
March 18, 2019 - Intellipharmaceutics Announces Resubmission of New Drug Application to the U.S. FDA for its Oxycodone ER
March 18, 2019 - Excessive gestational weight gain tied to maternal morbidity
March 18, 2019 - RCEM issues position statement on metrics to supplement four-hour standard target
March 17, 2019 - Noncontrast Brain MRI Effective for Monitoring Multiple Sclerosis
March 17, 2019 - Brain region plays key role in regulation of parenting behavior, study finds
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