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[Treatment-resistant mood disorders].

Rodrigo Machado-Vieira1, Jair C Soares

  • 1Programa de Transtornos do Humor e Ansiedade, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20892-3711, USA. machadovieirar@terra.com.br

Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999)
|August 24, 2007
PubMed
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Treatment resistance in mood disorders is common. Novel strategies targeting brain plasticity, such as antiglutamatergic drugs, offer promising therapeutic options for difficult-to-treat mood disorders.

Area of Science:

  • Neuroscience
  • Psychiatry

Context:

  • Mood disorders, including bipolar disorder and recurrent depression, exhibit high prevalence and recurrence rates.
  • Treatment resistance and persistent sub-syndromal symptoms remain significant clinical challenges.

Purpose:

  • This literature review evaluates current concepts of treatment resistance and refractoriness in mood disorders.
  • To identify and assess emerging therapeutic strategies for mood disorders that do not respond to conventional treatments.

Summary:

  • Refractory mood disorders stem from genetic factors, misdiagnosis, suboptimal pharmacotherapy, non-compliance, and stressors.
  • Standard treatments targeting the monoaminergic system may have limited efficacy in treatment-resistant cases.
  • Sequential augmentation and switching of agents are common but often insufficient strategies.

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Impact:

  • Emerging strategies focusing on brain plasticity, including antiglutamatergic drugs, glucocorticoid receptor antagonists, and neuropeptides, show promise.
  • These novel approaches could lead to more effective treatments for patients with difficult-to-treat mood disorders.
  • Addressing treatment resistance is critical for reducing the overall morbidity associated with mood disorders.