Treatment resistance in bipolar disorders

Abstract

Bipolar disorder (BD) is among the most prevalent and incapacitating severe mental illnesses. Although the rates of resistance to treatment among bipolar patients are not known, literature findings suggest that partial or no response to conventional agents seems to be extremely common. The present chapter addresses the different issues involved in the phenomena of treatment resistance among bipolar patients. It begins with a discussion of the challenges surrounding the concept of resistant BD, followed by some discussion regarding the possible pathophysiological factors involved in the development of resistance. Next, possible therapeutic interventions aiming at the management of treatment-resistant patients are addressed, including the potential role of novel pharmacological agents, neurostimulation, and psychosocial interventions.