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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 depression 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.

April 2019

Last updated at: 1:56 am, 2nd April 2019
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Title Colour Legend:
Green - Topic summary is available.
Orange - Topic summary is being compiled.
Red - Topic summary has no current systematic review available.