Revolutionising bipolar disorder treatment: University of Otago’s approach to lithium therapy

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image: ©Vladimir Vladimirov | iStock

Associate Professor Ailsa McGregor from the University of Otago’s School of Pharmacy has set on a mission to enhance the efficacy and safety of lithium treatment for patients battling bipolar disorder (BD)

Bipolar disorder is among the top ten most debilitating non-communicable diseases globally.

Medications available for bipolar disorder

Recognising lithium’s potential but also its significant drawbacks, McGregor and her team have secured $150,000 from the Health Research Council to move their creative research forward. Current medications, while helpful, often fall short of managing the extreme mood swings characteristic of BD. Lithium stands out as a highly effective option, not only stabilising mood swings but also reducing the risk of suicide, a crucial benefit not offered by other medications.

However, lithium’s effectiveness is tempered by its narrow therapeutic range, where the line between a therapeutic dose and a toxic dose is thin. Prolonged use can lead to adverse effects on kidney and thyroid function, necessitating frequent blood tests for monitoring, a burdensome requirement for already struggling patients.

McGregor’s research aims to mitigate these challenges by “caging” lithium, a method that could potentially reduce its toxicity while maintaining its therapeutic benefits. This innovative approach not only seeks to optimise treatment outcomes but also aims to alleviate the practical burdens faced by patients in managing their condition.

Bipolar disorder treatment

Central to McGregor’s study is the inclusion of patient perspectives and the cultural acceptability of the modified lithium treatment. This aspect is particularly significant for Māori communities, who are disproportionately affected by BD compared to other ethnic groups in New Zealand. By incorporating a te ao Māori worldview into drug development, McGregor hopes to ensure that the new treatment meets the needs and preferences of all patients, enhancing its acceptance and effectiveness.

The research team comprises a diverse group of experts, including Professor Christian Hartinger and Associate Professor Dave Goldstone from the University of Auckland, and clinical directors such as Dr. Ian Soosay and Dr. Kiri Prentice, who bring invaluable insights from their frontline experience in mental health and addiction services.

McGregor emphasises that the study’s transdisciplinary and translational approach will not only advance scientific understanding but also enable meaningful improvements in patient care. By integrating feedback from patients directly into the development process, McGregor and her team are pioneering a model of “reverse translation,” where patient insights inform the evolution of medical treatments.

With the support of the Health Research Council and collaborative efforts across disciplines and communities, McGregor’s research promises to redefine the landscape of bipolar disorder treatment, offering hope for a future where patients can manage their condition more effectively and with greater ease.

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