PMID- 25377609
OWN - NLM
STAT- MEDLINE
DCOM- 20150720
LR  - 20141107
IS  - 1465-7309 (Electronic)
IS  - 1067-3229 (Linking)
VI  - 22
IP  - 6
DP  - 2014 Nov-Dec
TI  - Factors associated with lithium efficacy in bipolar disorder.
PG  - 353-7
LID - 10.1097/HRP.0000000000000006 [doi]
AB  - About one-third of lithium-treated, bipolar patients are excellent lithium 
      responders; that is, lithium monotherapy totally prevents further episodes of 
      bipolar disorder for ten years and more. These patients are clinically 
      characterized by an episodic clinical course with complete remission, a bipolar 
      family history, low psychiatric comorbidity, mania-depression episode sequences, 
      a moderate number of episodes, and a low number of hospitalizations in the 
      pre-lithium period. Recently, it has been found that temperamental features of 
      hypomania (a hyperthymic temperament) and a lack of cognitive disorganization 
      predict the best results of lithium prophylaxis. Lithium exerts a neuroprotective 
      effect, in which increased expression of brain-derived neurotrophic factor (BDNF) 
      and inhibition of the glycogen synthase kinase-3 (GSK-3) play an important role. 
      The response to lithium has been connected with the genotype of the BDNF gene and 
      serum BDNF levels. A better response to lithium is connected with the Met allele 
      of the BDNF Val/Met polymorphism, as is a hyperthymic temperament. Excellent 
      lithium responders have normal cognitive functions and serum BDNF levels, even 
      after long-term duration of the illness. The preservation of cognitive functions 
      in long-term lithium-treated patients may be connected with the stimulation of 
      the BDNF system, with the resulting prevention of affective episodes exerting 
      deleterious cognitive effects, and possibly also with lithium's antiviral 
      effects. A number of candidate genes that are related to neurotransmitters, 
      intracellular signaling, neuroprotection, circadian rhythms, and other pathogenic 
      mechanisms of bipolar disorder were found to be associated with the lithium 
      prophylactic response. The Consortium on Lithium Genetics (ConLiGen) has recently 
      performed the first genome-wide association study on the lithium response in 
      bipolar disorder.
FAU - Rybakowski, Janusz K
AU  - Rybakowski JK
AD  - From the Department of Adult Psychiatry, Poznan University of Medical Sciences, 
      Poznan, Poland.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Harv Rev Psychiatry
JT  - Harvard review of psychiatry
JID - 9312789
RN  - 0 (Lithium Compounds)
RN  - 0 (Psychotropic Drugs)
SB  - IM
MH  - Bipolar Disorder/*drug therapy/genetics/psychology
MH  - Humans
MH  - Lithium Compounds/*therapeutic use
MH  - Psychotropic Drugs/*therapeutic use
MH  - Temperament
MH  - Treatment Outcome
EDAT- 2014/11/08 06:00
MHDA- 2015/07/21 06:00
CRDT- 2014/11/08 06:00
PHST- 2014/11/08 06:00 [entrez]
PHST- 2014/11/08 06:00 [pubmed]
PHST- 2015/07/21 06:00 [medline]
AID - 00023727-201411000-00008 [pii]
AID - 10.1097/HRP.0000000000000006 [doi]
PST - ppublish
SO  - Harv Rev Psychiatry. 2014 Nov-Dec;22(6):353-7. doi: 10.1097/HRP.0000000000000006.