Predicting Lithium Response

Peter Forster Bipolar Treatment Leave a Comment

Lithium is usually considered the most effective treatment for bipolar disorder. However, at least 30% of lithium-treated patients do not have a clinically significant response; and only 30% have a long-lasting full response. Since close laboratory monitoring is required, and adverse effects are not uncommon, identifying predictors of lithium response is highly desirable. In this largest-ever study of lithium recipients …

Lithium Associated Hypothyroidism May Be Reversible

Peter Forster Bipolar Treatment, Physical Conditions and Health Leave a Comment

People who develop hypothyroidism while using the mood stabilizer lithium may return to normal thyroid function after the drug is discontinued, according to a study in the Journal of Psychopharmacology. Hypothyroidism—a condition in which the thyroid gland does not produce enough thyroid hormone—has long been known to be associated with the use of lithium. Recent studies have clarified the nature of this association. …

Predicting Lithium Response with Functional Brain Imaging

Predicting Lithium Response with Brain Imaging

Peter Forster Bipolar Treatment, Testing Leave a Comment

Predicting lithium response with brain imaging may be an option in the future if the preliminary results of a study published in 2017 are confirmed. Researchers from the University of Cincinnati used three tools to create a program that was remarkably successful at predicting which bipolar patients would respond to lithium. 20 first onset bipolar patients who received adequate trials …

Lithium Mechanism of Action

Peter Forster Basic Science, Bipolar Treatment, Psychobiology 2 Comments

Understanding the lithium mechanism of action may allow us to predict which bipolar patients will respond to the medication (and which will not) and may shape our understanding of the causes of bipolar disorder itself. Research at the University of California, San Diego could lead to just these kind of breakthroughs in the next few years. In the first of …

Mood Stabilizers

Peter Forster Bipolar Treatment

There is nothing like a patient’s request to spur me on to tackle a long delayed project. Noting that a significant percent of the patients I see have bipolar, one of my patients wondered why I did not have any information on this website that addressed, in an organized way, the considerations that go into selecting a mood stabilizer. I …

Mania and Depression Sequence

Peter Forster Best Practices, Bipolar Treatment

One of the key features of bipolar disorder that, in our experience, is most useful in predicting treatment response is the usual sequence of manic (or hypomanic) and depressive episodes. For years we have used the mnemonics MDI and DMI as ways of categorizing patients’ course. But we could not find the reference to that idea. We are indebted to …

Lithium Prevents Suicide

Peter Forster Bipolar Treatment

This has been a year with lots of useful information highlighting the continued importance of some of the oldest treatments for bipolar disorder: lithium salts. A New York Times Magazine article (“I Don’t Believe in Good but I Believe in LIthium”) about bipolar focused on lithium, and another New York Times article a year before that asked the question “Should We …

Lithium and Genes

Peter Forster Bipolar Treatment, Psychobiology, Testing

Several studies have suggested that lithium response has a genetic component. Whether someone with bipolar will respond to treatment with lithium seems to be strongly associated with the presence or absence of a family history of response to the medication. A recent article in the Lancet reports the results of a genome-wide association study of lithium response in 2563 patients collected …