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Clinical Predictors Relevant to Lithium Response

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The Science and Practice of Lithium Therapy

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Abstract

To adequately evaluate lithium response, one needs to consider the whole clinical profile of bipolar disorder; it is not sufficient just to consider symptoms. Clinical variables based on the anamnesis are still the best predictors of lithium response. A later age of disease onset, an episodic course characterized by a pattern of mania followed by depression, fewer hospitalizations preceding treatment and the absence of an episodic pattern of depression-mania interval and continuous cycling should give the physician some hope of making the right decisions. The possible future addition of biological or brain imaging signatures should provide valuable information that would help in several ways: by more powerfully predicting response in conjunction with genotypes, by serving as a biomarker of response in clinical trials and by revealing pathophysiological pathways from gene to clinical success. Because of their relative homogeneity, lithium responders represent an important population for psychiatric research. This group of bipolar patients can thus be regarded as a good candidate population to open new fields of biological investigation, especially in the research of biomarkers of lithium response.

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Authors and Affiliations

  1. Department of Psychiatry (Dr. Marcel), Centre Hospitalier Sainte Anne (Secteur 3, Dr Marcel), 1 rue Cabanis, 75014, Paris, France

    Thomas Mauras MD

  2. Université Paris Descartes, UMR-S 1144, Paris, 75006, France

    Sarah Sportiche

  3. Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris, 75013, France

    Sarah Sportiche

  4. Département de Psychiatrie et de Médecine Addictologique, AP-HP, GH Saint-Louis – Lariboisière – F. Widal, Paris, Cedex, 10 75475, France

    Sarah Sportiche

  5. Hôtel-Dieu de France, Service de psychiatrie, Université Saint-Joseph, Département de Psychiatrie, BP 166830, Beyrouth, Lebanon

    Sami Richa

  6. Clinique du Château, 11bis rue de la Porte Jaune, 92380, Garches, France

    Marc Masson

  7. Pôle de psychiatrie du Professeur Raphaël Gaillard, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, 75014, Paris, France

    Marc Masson

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  1. Thomas Mauras MD
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  2. Sarah Sportiche
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Correspondence to Thomas Mauras MD .

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Editors and Affiliations

  1. Academic Department of Psychiatry, Sydney Medical School The University of Sydney, Sydney, Australia

    Gin S. Malhi

  2. Nightingale Hospitals Paris-Clinique du Château de Garches, Consultant Service Hospitalo-Universitaire Centre Hospitalier Sainte-Anne, Paris, France

    Marc Masson

  3. Publique – Hôpitaux de Paris, INSERM UMR-S1144 Paris-Diderot University, Paris, France

    Frank Bellivier

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Mauras, T., Sportiche, S., Richa, S., Masson, M. (2017). Clinical Predictors Relevant to Lithium Response. In: Malhi, G., Masson, M., Bellivier, F. (eds) The Science and Practice of Lithium Therapy. Springer, Cham. https://doi.org/10.1007/978-3-319-45923-3_7

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