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Treatment-resistant bipolar disorder.

M J Gitlin1

  • 1Department of Psychiatry, UCLA School of Medicine, USA.

Bulletin of the Menninger Clinic
|April 3, 2001
PubMed
Summary
This summary is machine-generated.

Newer pharmacotherapies for bipolar disorder show promise, particularly anticonvulsants like lamotrigine for depression. Research is ongoing for other treatments, including novel antipsychotics and adjunctive strategies.

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Area of Science:

  • Pharmacology
  • Psychiatry
  • Neurology

Background:

  • The pharmacotherapy landscape for bipolar disorder has expanded significantly.
  • Evidence for many newer treatments is primarily based on case reports and series.
  • Anticonvulsants and novel antipsychotics represent promising avenues for treatment.

Purpose of the Study:

  • To review recent advancements in pharmacotherapies for bipolar disorder.
  • To highlight the efficacy and limitations of emerging treatments.
  • To discuss alternative and adjunctive strategies for treatment-resistant cases.

Main Methods:

  • Literature review of recent studies on bipolar disorder pharmacotherapy.
  • Analysis of evidence quality for novel treatments.

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  • Discussion of treatment combinations and resistant cases.
  • Main Results:

    • Lamotrigine demonstrates efficacy in bipolar depression; gabapentin requires further controlled studies.
    • Topiramate, an anticonvulsant, is noted for weight loss effects.
    • Novel antipsychotics are effective for acute mania, but long-term mood-stabilizing effects require more research.
    • Combination therapies require careful consideration of pharmacokinetic interactions.
    • Other options for treatment-resistant bipolar disorder include thyroid hormones, calcium channel blockers, electroconvulsive therapy, and omega-3 fatty acids.

    Conclusions:

    • Recent pharmacotherapies offer new hope for bipolar disorder management, with anticonvulsants and novel antipsychotics showing particular potential.
    • Further controlled studies are needed to establish the efficacy of many newer agents.
    • Adjunctive psychosocial strategies are an active area of investigation for comprehensive bipolar disorder treatment.