Genetics and antiepileptic mood stabilizer treatment response in bipolar disorder: what do we know?

Pharmacogenomics. 2021 Sep;22(14):913-925. doi: 10.2217/pgs-2021-0041. Epub 2021 Sep 6.

Abstract

Antiepileptic mood stabilizers (AED-MS) are often used to treat bipolar disorder (BD). Similar to other mood disorder medications, AED-MS treatment response varies between patients. Identification of biomarkers associated with treatment response may ultimately help with the delivery of individualized treatment and lead to improved treatment efficacy. Here, we conducted a narrative review of the current knowledge of the pharmacogenomics of AED-MS (valproic acid, lamotrigine and carbamazepine) treatment response in BD, including genetic contributions to AED-MS pharmacokinetics. Genes involved in neurotransmitter systems and drug transport have been shown to be associated with AED-MS treatment response. As more studies are conducted, and experimental and analytical methods advance, knowledge of AED-MS pharmacogenomics is expected to grow and contribute to precision medicine in BD.

Keywords: anticonvulsants; antiepileptics; bipolar disorder; mood stabilizers; pharmacogenomics; treatment response.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticonvulsants / therapeutic use*
  • Antimanic Agents / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Bipolar Disorder / drug therapy*
  • Bipolar Disorder / genetics*
  • Carbamazepine / therapeutic use*
  • Humans
  • Lamotrigine / therapeutic use*
  • Mood Disorders / drug therapy
  • Mood Disorders / genetics
  • Treatment Outcome
  • Valproic Acid / therapeutic use*

Substances

  • Anticonvulsants
  • Antimanic Agents
  • Antipsychotic Agents
  • Carbamazepine
  • Valproic Acid
  • Lamotrigine