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Treatment-resistant bipolar depression: towards a new definition.

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Title: Treatment-resistant bipolar depression: towards a new definition.
Authors: Pacchiarotti, I. (AUTHOR), Mazzarini, L. (AUTHOR), Colom, F. (AUTHOR), Sanchez‐Moreno, J. (AUTHOR), Girardi, P. (AUTHOR), Kotzalidis, G. D. (AUTHOR), Vieta, E. (AUTHOR)
Source: Acta Psychiatrica Scandinavica. Dec2009, Vol. 120 Issue 6, p429-440. 12p. 1 Diagram, 2 Charts.
Subjects: Bipolar disorder, Mental depression, Clinical trials, Therapeutics, Anticonvulsants
Abstract: Objective: To summarize the conceptual and operational definitions of treatment-resistant bipolar depression and to review the evidence-based therapeutic options. Method: Structured searches of PubMed, Index Medicus, Excerpta Medica and Psyclit conducted in December 2008. Results: Criteria for treatment resistance in bipolar depression are commonly based on concepts stemming from treatment resistance as defined for unipolar depression, an approach that proved to be inadequate. In fact, the addition of an ad hoc criterion based on lithium and other mood stabilizer unresponsiveness after reaching adequate plasma levels appears to be a patch that attempts to take into account the uniqueness of bipolar depression but fails to become operational. Recent data from randomized clinical trials of new anticonvulsants and second-generation antipsychotics should lead to the development of a modern definition of treatment-resistant bipolar depression, and specific therapeutic algorithms. Conclusion: We suggest a redefinition of resistant bipolar I and II depression. We propose different degrees of severity within bipolar depression in a stepwise manner. [ABSTRACT FROM AUTHOR]
Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Treatment-resistant bipolar depression: towards a new definition.
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  Data: <searchLink fieldCode="AR" term="%22Pacchiarotti%2C+I%2E%22">Pacchiarotti, I.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mazzarini%2C+L%2E%22">Mazzarini, L.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Colom%2C+F%2E%22">Colom, F.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sanchez‐Moreno%2C+J%2E%22">Sanchez‐Moreno, J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Girardi%2C+P%2E%22">Girardi, P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Kotzalidis%2C+G%2E+D%2E%22">Kotzalidis, G. D.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vieta%2C+E%2E%22">Vieta, E.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Acta+Psychiatrica+Scandinavica%22">Acta Psychiatrica Scandinavica</searchLink>. Dec2009, Vol. 120 Issue 6, p429-440. 12p. 1 Diagram, 2 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Bipolar+disorder%22">Bipolar disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+trials%22">Clinical trials</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink><br /><searchLink fieldCode="DE" term="%22Anticonvulsants%22">Anticonvulsants</searchLink>
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  Data: Objective: To summarize the conceptual and operational definitions of treatment-resistant bipolar depression and to review the evidence-based therapeutic options. Method: Structured searches of PubMed, Index Medicus, Excerpta Medica and Psyclit conducted in December 2008. Results: Criteria for treatment resistance in bipolar depression are commonly based on concepts stemming from treatment resistance as defined for unipolar depression, an approach that proved to be inadequate. In fact, the addition of an ad hoc criterion based on lithium and other mood stabilizer unresponsiveness after reaching adequate plasma levels appears to be a patch that attempts to take into account the uniqueness of bipolar depression but fails to become operational. Recent data from randomized clinical trials of new anticonvulsants and second-generation antipsychotics should lead to the development of a modern definition of treatment-resistant bipolar depression, and specific therapeutic algorithms. Conclusion: We suggest a redefinition of resistant bipolar I and II depression. We propose different degrees of severity within bipolar depression in a stepwise manner. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Psychiatrica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=45090092
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        Value: 10.1111/j.1600-0447.2009.01471.x
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              Text: Dec2009
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