To mark World Bipolar Day (30 March 2019) we examine how genetic testing can improve the effectiveness of treatment for people with bipolar affective disorder (BPAD).
Who is affected by BPAD?
Roughly two per cent of the world’s population (48.8 million in 2013) is affected by BPAD. The condition is characterised by bouts of severe depression followed by episodes of mania.
When they are depressed, sufferers may experience low mood, lack of energy, loss of interest in activities they normally enjoy and negative thought patterns. If the depression becomes severe, it can affect sleep and lead to loss of appetite and even suicidal thoughts.
When people enter a manic phase, they become unpredictable and erratic and may do things that are out of character, such as spending large amounts of money or engaging in superficial relationships. Irritability, impatience and aggression are common and conflicts can develop.
Depression and mania can follow one another in close succession or can be interspersed with periods of normal mental health. The condition can severely impact a person’s life and may lead to admission to psychiatric inpatient units for treatment, sometimes against the person’s will.
Treatment of bipolar disease
Mood stabilising medication is generally prescribed for people with BPAD. The aim is to treat episodes and prevent relapse. Sufferers are generally prescribed one or more of the following medications:
- lithium salts which helps to treat acute mania and protect against further episodes, as well as enhancing antidepressant treatments
- and anti-epileptics.
The difficulty with treating BPAD is that it is impossible to predict which medication or combination of medications will work for which patient.
Less than a third of patients (30%) respond fully to lithium and they may need other medications to be added to keep the condition under control.
For another 30%, there is no benefit whatsoever from lithium treatment and other mood stabilisers need to be prescribed instead.
This means that doctors have to rely on a process of trial and error to identify the right treatment. In some cases it can take years before the optimum combination is found. In the meantime, patients will continue to suffer debilitating symptoms, relapses and side-effects from medication that may not produce any benefits.
Benefits of genetic testing for bipolar treatment
This is why genetic testing is such a significant advance in the treatment of bipolar disorder. Referred to as personalised medicine, it matches the medication to the individual’s unique genetic profile.
Myogenes is at the forefront of personalised medicine and has developed The Genecept Assay, which helps doctors to make the best treatment decisions for patients with mental illnesses like Bipolar Affective Disorder.
How it works
Using a simple cheek swab, it identifies patient-specific genetic markers that identify which medications are likely to work as intended without causing unpleasant side effects. The test can only be administered by a doctor, clinician or psychiatric consultant who then sends it away to the lab for analysis.
Your doctor will then receives a personalised patient report outlining the lab findings. This enables them to make better prescribing decisions and helps the patient feel better faster, as well as reducing the cost of prescribing unnecessary or ineffective medications.