Treatment-resistant bipolar depression: concepts and challenges for novel interventions

Detalhes bibliográficos
Autor(a) principal: Diaz,Alexandre P.
Data de Publicação: 2022
Outros Autores: Fernandes,Brisa S., Quevedo,Joao, Sanches,Marsal, Soares,Jair C.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462022000200178
Resumo: 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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spelling Treatment-resistant bipolar depression: concepts and challenges for novel interventionsBipolar disorderdepressiontreatment-resistant bipolar disorderTreatment-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.Associação Brasileira de Psiquiatria2022-04-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462022000200178Brazilian Journal of Psychiatry v.44 n.2 2022reponame:Brazilian Journal of Psychiatry (São Paulo. 1999. Online)instname:Associação Brasileira de Psiquiatria (ABP)instacron:ABP10.1590/1516-4446-2020-1627info:eu-repo/semantics/openAccessDiaz,Alexandre P.Fernandes,Brisa S.Quevedo,JoaoSanches,MarsalSoares,Jair C.eng2022-04-25T00:00:00Zoai:scielo:S1516-44462022000200178Revistahttp://www.bjp.org.br/ahead_of_print.asphttps://old.scielo.br/oai/scielo-oai.php||rbp@abpbrasil.org.br1809-452X1516-4446opendoar:2022-04-25T00:00Brazilian Journal of Psychiatry (São Paulo. 1999. Online) - Associação Brasileira de Psiquiatria (ABP)false
dc.title.none.fl_str_mv Treatment-resistant bipolar depression: concepts and challenges for novel interventions
title Treatment-resistant bipolar depression: concepts and challenges for novel interventions
spellingShingle Treatment-resistant bipolar depression: concepts and challenges for novel interventions
Diaz,Alexandre P.
Bipolar disorder
depression
treatment-resistant bipolar disorder
title_short Treatment-resistant bipolar depression: concepts and challenges for novel interventions
title_full Treatment-resistant bipolar depression: concepts and challenges for novel interventions
title_fullStr Treatment-resistant bipolar depression: concepts and challenges for novel interventions
title_full_unstemmed Treatment-resistant bipolar depression: concepts and challenges for novel interventions
title_sort Treatment-resistant bipolar depression: concepts and challenges for novel interventions
author Diaz,Alexandre P.
author_facet Diaz,Alexandre P.
Fernandes,Brisa S.
Quevedo,Joao
Sanches,Marsal
Soares,Jair C.
author_role author
author2 Fernandes,Brisa S.
Quevedo,Joao
Sanches,Marsal
Soares,Jair C.
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Diaz,Alexandre P.
Fernandes,Brisa S.
Quevedo,Joao
Sanches,Marsal
Soares,Jair C.
dc.subject.por.fl_str_mv Bipolar disorder
depression
treatment-resistant bipolar disorder
topic Bipolar disorder
depression
treatment-resistant bipolar disorder
description 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.
publishDate 2022
dc.date.none.fl_str_mv 2022-04-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462022000200178
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dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/1516-4446-2020-1627
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eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
publisher.none.fl_str_mv Associação Brasileira de Psiquiatria
dc.source.none.fl_str_mv Brazilian Journal of Psychiatry v.44 n.2 2022
reponame:Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
instname:Associação Brasileira de Psiquiatria (ABP)
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reponame_str Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
collection Brazilian Journal of Psychiatry (São Paulo. 1999. Online)
repository.name.fl_str_mv Brazilian Journal of Psychiatry (São Paulo. 1999. Online) - Associação Brasileira de Psiquiatria (ABP)
repository.mail.fl_str_mv ||rbp@abpbrasil.org.br
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