Genetics and Antiepileptic Mood Stabilizer Treatment Response in Bipolar Disorder: What do we Know?

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

Supplementary data

To view the supplementary data that accompany this paper please visit the journal website at: www.futuremedicine.com/doi/suppl/10.2217/pgs-2021-0041

Author contributions

AM-C Ho and JM Biernacka formed the concept of the work. AM-C Ho prepared the manuscript. RM Weinshilboum, MA Frye and JM Biernacka provided critical revision and important intellectual content. All authors approved the final version to be published and agreed to be accountable for all aspects the work.

Financial & competing interests disclosure

This research is supported by a gift from Kent and Liz Dauten and the Mayo Clinic Center for Individualized Medicine. RM Weinshilboum is a founder and shareholder in OneOme LLC, a pharmacogenomics decision support company. MA Frye has received grant support from Assurex Health, Myriad, Pfizer, Marriott Foundation and Mayo Foundation. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

This research is supported by a gift from Kent and Liz Dauten and the Mayo Clinic Center for Individualized Medicine. RM Weinshilboum is a founder and shareholder in OneOme LLC, a pharmacogenomics decision support company. MA Frye has received grant support from Assurex Health, Myriad, Pfizer, Marriott Foundation andMayo Foundation. The authors have no other relevant affiliationsor financial involvement with any organization or entity with afinancial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.No writing assistance was utilized in the production of this manuscript.