Personalizing lithium therapy: The role of pharmacogenomics in bipolar disorder

Lithium is a gold-standard medication for mood stabilizing in bipolar illness, but patient tolerability and response are highly variable. Such heterogeneity underscores the importance of individualized treatment modalities. Pharmacogenomics gives a glimpse into genetic determinants of lithium’s efficacy, metabolism, and toxicity. Genetic variants in GSK3 β, BDNF, INPP1, and SLC22A6 have been associated with response to treatment and side effects. Evidence for a genetic basis of lithium sensitivity comes from genome-wide association studies such as the ConLi Gen Consortium. Incorporation of pharmacogenomic testing into clinical care would increase therapeutic accuracy, reduce adverse effects, and improve outcomes. There are, however, issues of limited replication between populations, ethics, and costs of implementation to overcome. Future studies that combine multi-omics and artificial intelligence models are promising for translating pharmacogenomic information into precision psychiatry, advancing lithium treatment toward individualized, evidence-guided care.