Variant GADL1 and Response to Lithium Therapy in Bipolar I Disorder

• Published in: The New England journal of medicine Vol. 370; no. 2; pp. 119 - 128
• Main Authors: Chen, Chien-Hsiun, Lee, Chau-Shoun, Lee, Ming-Ta Michael, Ouyang, Wen-Chen, Chen, Chiao-Chicy, Chong, Mian-Yoon, Wu, Jer-Yuarn, Tan, Happy Kuy-Lok, Lee, Yi-Ching, Chuo, Liang-Jen, Chiu, Nan-Ying, Tsang, Hin-Yeung, Chang, Ta-Jen, Lung, For-Wey, Chiu, Chen-Huan, Chang, Cheng-Ho, Chen, Ying-Sheue, Hou, Yuh-Ming, Chen, Cheng-Chung, Lai, Te-Jen, Tung, Chun-Liang, Chen, Chung-Ying, Lane, Hsien-Yuan, Su, Tung-Ping, Feng, Jung, Lin, Jin-Jia, Chang, Ching-Jui, Teng, Po-Ren, Liu, Chia-Yih, Chen, Chih-Ken, Liu, I-Chao, Chen, Jiahn-Jyh, Lu, Ti, Fan, Chun-Chieh, Wu, Ching-Kuan, Li, Chang-Fang, Wang, Kathy Hsiao-Tsz, Wu, Lawrence Shih-Hsin, Peng, Hsin-Ling, Chang, Chun-Ping, Lu, Liang-Suei, Chen, Yuan-Tsong, Cheng, Andrew Tai-Ann
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 09.01.2014
• Subjects: Adult; Adult and adolescent clinical studies; Affective disorders; Aged; Aged, 80 and over; Antimanic Agents - therapeutic use; Asian Continental Ancestry Group; Biological and medical sciences; Bipolar disorder; Bipolar Disorder - drug therapy; Bipolar Disorder - ethnology; Bipolar Disorder - genetics; Bipolar disorders; Carboxy-Lyases - genetics; China; Exons; Female; General aspects; Genetic diversity; Genome-Wide Association Study; Genotype; Glutamate decarboxylase; Humans; Introns; Linkage Disequilibrium; Lithium; Lithium - therapeutic use; Maintenance Chemotherapy; Male; Medical sciences; Mental depression; Mental disorders; Middle Aged; Mood disorders; Patients; Phenotype; Polymorphism, Single Nucleotide; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Replication; Single-nucleotide polymorphism; Splicing; Young Adult; China; Taiwan; Mood disorder; Medicine; Bipolar disorder; Treatment
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1212444

The response to lithium for the treatment of bipolar disease is variable. This genetic study showed a strong association between variants in GADL1 and response to treatment in Han Chinese patients with bipolar I disease. Bipolar disorder is a disabling mental illness that is characterized by episodes of both elevated or irritable mood and depression. 1 , 2 Currently, lithium is the first-line choice for maintenance treatment of bipolar disorder and reduces the risks of relapse and suicide. 3 – 5 Approximately 80% of patients with bipolar I disorder who are treated with lithium over the long term have at least a partial response, 6 and 30% have an excellent response 7 , 8 with complete remission of symptoms observed in populations of patients of European descent. Clinical predictors of a good response to lithium treatment have been reported, such as age . . .