These days, lithium is seen by many to be a sort of “gold standard” drug when it comes to treating bipolar disorder, but it is clear that everybody doesn’t react the same way to the drug; at least, that is what a new study published in BioMed Central’s open access journal Biology of Mood & Anxiety Disorders has found.

Researchers at Yale have discovered that lithium works for some people when it comes to their gene activation levels. This is particularly true when it comes to the activation or repression of genes that change apoptosis levels (programmed cell death). The Yale team did their research by measuring the varying gene activity levels in depressed patients’ blood before they received treatment for their bipolar disorder. They checked again 2 weeks later after the 20 patients had the lithium carbonate treatment. What they found was that the patients who received the lithium treatment showed definite changes in their gene expression levels.

“We found 127 genes that had different patterns of activity (turned up or down) and the most affected cellular signalling pathway was that controlled programmed cell death (apoptosis),” says Dr. Robert Beech, who led this study. “This positive swing in regulation of apoptosis for lithium responders was measurable as early as four weeks after the start of treatment, while in non-responders there was a measurable shift in the opposite direction. It seems then, that increased expression of BCL2 and related genes is necessary for the therapeutic effects of lithium. Understanding these differences in genes expression may lead towards personalized treatment for bipolar disorder in the future.”

Bipolar disorder is often treated with antidepressant medications like Paxil and Effexor. Both Paxil and Effexor have been linked to serious side effects, including violent thoughts and behavior and birth defects in babies born to mothers who take the drugs while pregnant. Some of those birth defects linked to Paxil and Effexor include PPHN, oral clefts, cleft palate, neural tube defects and heart, lung and brain defects.