Why lithium so often fails patients

An Australian team have found an important genetic clue

Researchers believe they are closer to knowing why so many bipolar patients don’t respond to lithium treatment.


It’s well known that about 30% of patients are only partially responsive to the drug, more than a quarter show no clinical response, and others have significant side-effects to lithium.

But the underlying biological mechanism behind these reactions has been unclear.

Now a team from the University of Adelaide say the answer may lie in the patients' genetic make-up.

Professor Bernhard Baune has led a study in which bipolar patients with a poor response to lithium all shared a high number of genes previously identified for schizophrenia.

"This doesn't mean that the patient also had schizophrenia – but if a bipolar patient has a high gene load of schizophrenia risk genes, our research shows they are less likely to respond to mood stabilisers such as lithium.”

In addition, his team identified new genes within the immune system that may play an important biological role in the underlying pathways of lithium and its effect on treatment response.

"These findings represent a significant step forward for the field of translational psychiatry," Professor Baune says.

"In conjunction with other biomarkers and clinical variables, our findings will help to advance the highly needed ability to predict the response to treatment prior to intervention.”

Read the full study here