Chapter 10 - Pharmacogenomics and mood stabilizers: efficacy and adverse drug reactions

Abstract

Lithium represents the mainstay treatment in the management of bipolar disorder (BD). However, only one-third of the patients show excellent response and no reliable biomarkers are ready to be implemented into the clinical practice. Research investigating pharmacogenomics of lithium response has recently moved from candidate gene to hypothesis-free genome-wide association studies, mainly thanks to international efforts such as the International Consortium on Lithium Genetics (ConLiGen). On the other hand, research investigating genetic variants underlying lithium-induced adverse drug reactions or pharmacogenomics of other mood stabilizers is still in its infancy. In this chapter we will provide an overview of the most important findings on pharmacogenomics of mood stabilizers in patients with BD. Promising biomarkers and signaling pathways, limitations and strengths of available studies, as well as future directions will be discussed.