ReviewCNS neuroscience & therapeutics2012
Refractoriness in bipolar disorder: definitions and evidence-based treatment.
Review in CNS neuroscience & therapeutics, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Challenges in defining treatment-resistant mania in adults: A systematic review.Bipolar disorders · 2024Pooled it
- A systematic review on gut-brain axis aberrations in bipolar disorder and methods of balancing the gut microbiota.Brain and behavior · 2023Pooled it
- The CINP Guidelines on the Definition and Evidence-Based Interventions for Treatment-Resistant Bipolar Disorder.The international journal of neuropsychopharmacology · 2020Pooled it
- Efficacy of pharmacotherapy in bipolar disorder: a report by the WPA section on pharmacopsychiatry.European archives of psychiatry and clinical neuroscience · 2012Pooled it
- The application of amplitude of low-frequency fluctuations metrics in the diagnosis and prediction of treatment response as well as their associated genes and biological processes in patients with bipolar disorder.Translational psychiatry · 2025Article
- New Episodes and Suicidal Risks in Bipolar and Major Depressive Disorder Patients During Versus Before Long-Term Treatment With Lithium.Acta psychiatrica Scandinavica · 2025Article
- Accelerated intermittent theta burst stimulation for pharmacological treatment-resistant bipolar depression: Protocol for double-blind, randomized, sham-controlled trial.PCN reports : psychiatry and clinical neurosciences · 2025Article
- Challenges in the development of treatment guidelines for bipolar disorder.Frontiers in psychiatry · 2025Article
- Differences in Symptoms Following Acupuncture Treatment in Three Case Presentations of Bipolar Disorder: Type 2, Comorbid Anxiety Disorder, and Rapid Cycling Type.Medical acupuncture · 2024Article
- Ketamine for Bipolar Depression: Biochemical, Psychotherapeutic, and Psychedelic Approaches.Frontiers in psychiatry · 2022Article
- Investigating the Role of Leukocyte Telomere Length in Treatment-Resistant Depression and in Response to Electroconvulsive Therapy.Journal of personalized medicine · 2021Article
- The Impact of Subsyndromal Bipolar Symptoms on Patient's Functionality and Quality of Life.Frontiers in psychiatry · 2020Review
- The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm.The international journal of neuropsychopharmacology · 2017Review
- Bupropion Maintenance Treatment in Refractory Bipolar Depression: A Case Report.Clinical practice and epidemiology in mental health : CP & EMH · 2017Article
- Does the "Clinical practice and epidemiology in mental health : CP & EMH · 2016Article
- Ketamine-an update on its clinical uses and abuses.CNS neuroscience & therapeutics · 2014Review
- Aripiprazole in the treatment of refractory mood disorders: a case series.Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology · 2014Article
Corrections and comments
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Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Defining refractoriness in bipolar disorder is complex and should concern and include either every phase and pole or the disorder as a whole. The data on the treatment of refractory bipolar patients are sparse. Combination and add-on studies suggest that in acutely manic patients partial responders to lithium, valproate, or carbamazepine, a good strategy would be to add haloperidol, risperidone, olanzapine, quetiapine, or aripiprazole. Adding oxcarbazepine to lithium is also a choice. There are no reliable data concerning the treatment of refractory bipolar depressives and also there is no compelling data for the maintenance treatment of refractory patients. It seems that patients stabilized on combination treatment might do worse if shifted from combination. Conclusively there are only limited and sometimes confusing data on the treatment of refractory bipolar patients. Further focused research is necessary on this group of patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.