Getting Closer to Personalized Medicine for Bipolar Disorder.

For patients living with Bipolar illness who have had several trials of medications (or cocktails of medications for that matter) without adequate response,  the devastation of one more medication that doesn’t do the trick can often lead to feelings of hopelessness.  Many patients give up on medication trials. Although I continue to see hope where they may not, I don’t blame them. It is the patient that waits that long month between visits.  They suffering through nuisance side effects, waiting for the medication to work, and joy at the thought that it is working only to fall into a depression the next week. For those that have struggled to find a medication that works, the process often contributes to the illness itself.  I explain to my patients that the field of Psychiatry is still a pseudoscience. It is not like breaking your leg. You can’t get an X-ray that definitively tells you what treatment you’ll need, and for exactly how many weeks.  But that’s all changing… Researchers in the fields of Psychiatry and Neuroscience are hard at work to increase the availability of objective data and testing for which prescribers can base their treatments off.  Lithium is a medication that can work wonders for those suffering from Bipolar disorder…or not at all.  Lithium requires slow titrations to a specific narrow therapeutic index, blood work, waiting, and more waiting. Many people brave through start up side effects and frequent trips to the lab in hopes of being rewarded for their patience and perseverance with relief.  Some, about 30%, will be, the other 70% will not.  In this piece, scientists explain how their research enables them to predict with 92% accuracy who those 30% will be. In addition to the contribution this type of research adds to patient’s treatment and well being, it may also provide a sense of validation for many patients.  Having objective reasons why a medication will work also helps to break down stereotypes about mental illness. If we have objective measures for treatments, that means there is something tangible that can be measured. This can help to remove the blame that patients so frequently place on themselves (or that others have placed on them for that matter). We are gaining speed on personalized medicine in Psychiatry which will hopefully open many new strategies to optimize patient treatment.

– Danielle Zito PMHCS BC

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