Treatment-resistant bipolar depression: concepts and challenges for novel interventions
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462022000200178 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1516-44462022000200178 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1516-4446-2020-1627 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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) instacron:ABP |
instname_str |
Associação Brasileira de Psiquiatria (ABP) |
instacron_str |
ABP |
institution |
ABP |
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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