Treatment-resistant bipolar depression: concepts and challenges for novel interventions
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
44(2): 178-186, Apr. 2022. tab, graf
Artigo
em Inglês
|
LILACS-Express
| LILACS
| ID: biblio-1374578
ABSTRACT
Treatment-resistant bipolar depression (TRBD) has been reported in about one-quarter of patients with bipolar disorders, and few interventions have shown clear and established effectiveness. We conducted a narrative review of the published medical literature to identify papers discussing treatment-resistant depression concepts and novel interventions for bipolar depression that focus on TRBD. We searched for potentially relevant English-language articles published in the last decade. Selected articles (based on the title and abstract) were retrieved for a more detailed evaluation. A number of promising new interventions, both pharmacological and non-pharmacological, are being investigated for TRBD treatment, including ketamine, lurasidone, D-cycloserine, pioglitazone, N-acetylcysteine, angiotensin-converting enzyme inhibitors, angiotensin II type 1 receptor blockers, cyclooxygenase 2 inhibitors, magnetic seizure therapy, intermittent theta-burst stimulation, deep transcranial magnetic stimulation, vagus nerve stimulation therapy, and deep brain stimulation. Although there is no consensus about the concept of TRBD, better clarification of the neurobiology associated with treatment non-response could help identify novel strategies. More research is warranted, mainly focusing on personalizing current treatments to optimize response and remission rates.
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Índice:
LILACS (Américas)
Idioma:
Inglês
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2022
Tipo de documento:
Artigo
País de afiliação:
Estados Unidos
Instituição/País de afiliação:
The University of Texas Health Science Center at Houston (UTHealth)/US
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