Prediction of clinical course of bipolar manic depressive illness treated with lithium

Area of Science:

• Neuroscience
• Biochemistry
• Psychiatry

Background:

• Bipolar disorder (manic depressive illness) is a mood disorder requiring long-term management.
• Lithium therapy is a cornerstone treatment for bipolar disorder, but predicting treatment response can be challenging.

Purpose of the Study:

• To investigate potential biomarkers for predicting clinical response to lithium therapy in bipolar disorder patients.
• To examine the relationship between erythrocyte Na-K ATPase activity, plasma and erythrocyte lithium concentrations, and prognosis in patients undergoing lithium treatment.

Main Methods:

• Investigated a cohort of bipolar disorder patients attending a lithium clinic.
• Measured erythrocyte sodium-potassium ATPase (Na-K ATPase) activity.
• Assessed plasma and erythrocyte lithium concentrations.
• Correlated these measures with clinical prognosis.

Main Results:

• Patients with a good prognosis on lithium therapy exhibited higher erythrocyte Na-K ATPase activity and higher plasma and erythrocyte lithium concentrations compared to those with a poor prognosis.
• A positive correlation was observed between plasma lithium concentration and Na-K ATPase activity.
• The erythrocyte to plasma lithium ratio was not found to be a useful predictor of clinical response.

Conclusions:

• Erythrocyte Na-K ATPase activity and lithium concentrations may serve as indicators of prognosis in bipolar disorder patients treated with lithium.
• Lithium treatment itself appears to increase erythrocyte Na-K ATPase activity in these patients.