Evidence-based treatments in therapy-resistant bipolar depression

Pascal Sienaert, Lore Lambrichts, Annemieke Dols, Jürgen De Fruyt

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Objective To present an overview of all available randomized trials on treatment strategies in patients with medication-resistant bipolar depression, a common clinical problem. DESIGN Systematic review. Method We carried out a Medline search for publications from 1966 to 2012 using the search terms 'treatment resistance' or 'treatment refractory', 'bipolar depression' and 'bipolar disorder', supplemented by 43 separate searches using various pharmacological agents or technical interventions as search terms. Results Only 7 studies met the inclusion criteria. These studies examined the efficacy of ketamine (n = 2), modafinil (n = 1), pramipexole (n = 1), lamotrigine (n = 1), inositol (n = 1), risperidone (n = 1), and electroconvulsion therapy (ECT) (n = 2). Conclusion Published data on treatment strategies in patients with therapy-resistant bipolar depression are extremely scarce. Although the drugs studied are very promising, most of the strategies - with the exception of ECT - remain experimental. There is an urgent need for further study in homogeneous patient samples in which the concept of treatment resistance should be clear.

Translated title of the contributionEvidence-based treatments in therapy-resistant bipolar depression
Original languageDutch
Article numberA6075
JournalNederlands Tijdschrift voor Geneeskunde
Volume157
Issue number37
Publication statusPublished - 14 Oct 2013

Cite this

Sienaert, Pascal ; Lambrichts, Lore ; Dols, Annemieke ; Fruyt, Jürgen De. / Evidencebased behandelingen van therapieresistente bipolaire depressie. In: Nederlands Tijdschrift voor Geneeskunde. 2013 ; Vol. 157, No. 37.
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Evidencebased behandelingen van therapieresistente bipolaire depressie. / Sienaert, Pascal; Lambrichts, Lore; Dols, Annemieke; Fruyt, Jürgen De.

In: Nederlands Tijdschrift voor Geneeskunde, Vol. 157, No. 37, A6075, 14.10.2013.

Research output: Contribution to journalReview articleAcademicpeer-review

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T1 - Evidencebased behandelingen van therapieresistente bipolaire depressie

AU - Sienaert, Pascal

AU - Lambrichts, Lore

AU - Dols, Annemieke

AU - Fruyt, Jürgen De

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N2 - Objective To present an overview of all available randomized trials on treatment strategies in patients with medication-resistant bipolar depression, a common clinical problem. DESIGN Systematic review. Method We carried out a Medline search for publications from 1966 to 2012 using the search terms 'treatment resistance' or 'treatment refractory', 'bipolar depression' and 'bipolar disorder', supplemented by 43 separate searches using various pharmacological agents or technical interventions as search terms. Results Only 7 studies met the inclusion criteria. These studies examined the efficacy of ketamine (n = 2), modafinil (n = 1), pramipexole (n = 1), lamotrigine (n = 1), inositol (n = 1), risperidone (n = 1), and electroconvulsion therapy (ECT) (n = 2). Conclusion Published data on treatment strategies in patients with therapy-resistant bipolar depression are extremely scarce. Although the drugs studied are very promising, most of the strategies - with the exception of ECT - remain experimental. There is an urgent need for further study in homogeneous patient samples in which the concept of treatment resistance should be clear.

AB - Objective To present an overview of all available randomized trials on treatment strategies in patients with medication-resistant bipolar depression, a common clinical problem. DESIGN Systematic review. Method We carried out a Medline search for publications from 1966 to 2012 using the search terms 'treatment resistance' or 'treatment refractory', 'bipolar depression' and 'bipolar disorder', supplemented by 43 separate searches using various pharmacological agents or technical interventions as search terms. Results Only 7 studies met the inclusion criteria. These studies examined the efficacy of ketamine (n = 2), modafinil (n = 1), pramipexole (n = 1), lamotrigine (n = 1), inositol (n = 1), risperidone (n = 1), and electroconvulsion therapy (ECT) (n = 2). Conclusion Published data on treatment strategies in patients with therapy-resistant bipolar depression are extremely scarce. Although the drugs studied are very promising, most of the strategies - with the exception of ECT - remain experimental. There is an urgent need for further study in homogeneous patient samples in which the concept of treatment resistance should be clear.

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