Treatments for medication resistance

What is medication resistance?

Bipolar disorder is a persistent, episodic, and debilitating condition associated with recurring episodes of mania, hypomania, depression, and mixed manic-depressive states. These symptoms can lead to severe functional impairment, substance abuse, and suicidal behaviour. Treatment guidelines advocate the use of individual medications, with multiple medications indicated when a patient relapses on maintenance treatment. Unsatisfactory response to therapies is common in bipolar disorder, particularly during depressive episodes. Hence, there is a need to study medications that specifically target people with treatment resistance.

What is the evidence for medication-resistance?

Moderate to low quality evidence suggests clozapine and triiodothyronine may be effective for people with treatment-resistant bipolar disorder, although possible side effects of clozapine require careful monitoring. The remainder of the samples were too small (<100 patients) to draw definitive conclusions for other medications, however, review authors suggest there are encouraging findings for adjunctive aripiprazole, bupropion, ketamine, memantine, pramipexole, and pregabalin.

July 2020

Last updated at: 2:43 am, 9th July 2020
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