Abstract
Bipolar disorder is prevalent, with high risks of disability, substance abuse and premature mortality. Treatment responses typically are incomplete, especially for depressive components, so that many cases can be considered “treatment resistant.” We reviewed reports on experimental treatments for such patients: there is a striking paucity of such research, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary. Encouraging results have been reported by adding aripiprazole, bupropion, clozapine, ketamine, memantine, pramipexole, pregabalin, and perhaps tri-iodothyronine in resistant manic or depressive phases. The urgency of incomplete responses in such a severe illness underscores the need for more systematic, simpler, and better controlled studies in more homogeneous samples of patients.
Keywords: Bipolar disorder, depression, experimental treatments, mania, treatment-resistance.
Graphical Abstract
Current Neuropharmacology
Title:Pharmacological Approaches for Treatment-resistant Bipolar Disorder
Volume: 13 Issue: 5
Author(s): Shi Hui Poon, Kang Sim and Ross J. Baldessarini
Affiliation:
Keywords: Bipolar disorder, depression, experimental treatments, mania, treatment-resistance.
Abstract: Bipolar disorder is prevalent, with high risks of disability, substance abuse and premature mortality. Treatment responses typically are incomplete, especially for depressive components, so that many cases can be considered “treatment resistant.” We reviewed reports on experimental treatments for such patients: there is a striking paucity of such research, mainly involving small incompletely controlled trials of add-on treatment, and findings remain preliminary. Encouraging results have been reported by adding aripiprazole, bupropion, clozapine, ketamine, memantine, pramipexole, pregabalin, and perhaps tri-iodothyronine in resistant manic or depressive phases. The urgency of incomplete responses in such a severe illness underscores the need for more systematic, simpler, and better controlled studies in more homogeneous samples of patients.
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Cite this article as:
Hui Poon Shi, Sim Kang and J. Baldessarini Ross, Pharmacological Approaches for Treatment-resistant Bipolar Disorder, Current Neuropharmacology 2015; 13 (5) . https://dx.doi.org/10.2174/1570159X13666150630171954
DOI https://dx.doi.org/10.2174/1570159X13666150630171954 |
Print ISSN 1570-159X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6190 |
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