The identification of biomarkers predicting acute and maintenance lithium treatment response in bipolar disorder: A plea for further research attention

• Published in: Psychiatry research 2018-11, Vol.269, p.658-672
• Main Authors: Fornaro, Michele, De Berardis, Domenico, Anastasia, Annalisa, Novello, Stefano, Fusco, Andrea, Cattaneo, Carlo Ignazio, Solmi, Marco, Monaco, Francesco, Veronese, Nicola, Kim, Yong-Ku, de Bartolomeis, Andrea
• Format: Article
• Language: English
• Subjects: Acute; Biomarker; Biomarkers; Biomedical Research - methods; Biomedical Research - trends; Bipolar disorder (BD); Bipolar Disorder - diagnosis; Bipolar Disorder - drug therapy; Bipolar Disorder - psychology; Humans; Lithium; Lithium - pharmacology; Lithium - therapeutic use; Maintenance; Predictive Value of Tests; Predictor; Prospective Studies; Response; Retrospective Studies; Treatment Outcome
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2018.08.034

•Lithium represents the mainstream treatment for bipolar disorder (BD), yet prediction of either acute- or long-term response could not be exhaustively cast based on clinical variables.•A number of putative biomarkers have been investigated on the matter.•The present systematic review could highlight a handful of acute (n = 16) and maintenance studies (n = 12) studies eligible for inclusion owing to strict inclusion criteria.•The present review solicits the need for further research on the matter and more permissive inclusion criteria. The prediction of acute and maintenance lithium treatment response carries major clinical and neurobiological implications, warranting systematic review. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) compliant review searched major electronic databases from inception until December 2017 for studies documenting a clinical diagnosis of bipolar disorder (BD) made according to the mainstream diagnostic manuals and confirmed by a structured interview. Eligible studies allowed a quantitative comparison of endpoint vs baseline mean values of a given biomarker, regardless of the mood phase of patients with BD, and the disorder was assessed for severity using validated rating tool(s). Owing to the purposely applied stringent selection criteria, 16 acute and 12 maintenance studies could be included. The anticipated publication bias limited the chances of reportable generalizable findings, hindering a side-by-side comparison of different records across varying biomarkers and subsequent meta-analyses. The PRISMA approach was nonetheless preferred; it aimed at enhancing the homogeneity of the included results and minimizing the chances of “apples and oranges” with respect to the present research theme. The present critical review confirms the need for future research to specifically assess either pretreatment and/or posttreatment putative biomarkers of patients with BD and treated with lithium.