title: Pharmacological Approaches for Treatment-resistant Bipolar Disorder.
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.
authors.forename: Shi
authors.initials: S
authors.lastname: Hui Poon
authors.forename: Kang
authors.initials: K
authors.lastname: Sim
authors.affiliation: Department of General Psychiatry, Institute of Mental Health, 10, Buangkok View, Singapore 539747.
authors.forename: Ross J
authors.initials: RJ
authors.lastname: Baldessarini
mesh_terms: D000818:Animals; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans
chemical_list: D000928:Antidepressive Agents