Some Ideas for Handling Treatment-Resistant Bipolar Disorder

Bipolar disorder is being better understood each day. There is also ongoing research into its treatment. But successfully treating bipolar disorder can involve several medication trials, and it can take years to achieve remission. Even if remission is attained, recurrence is the rule — not the exception. It’s not uncommon for all first-line treatments to be exhausted. People in this situation may be considered by mental health professionals to be treatment-resistant. Luckily, there are treatments that can be tried when first-line, and even second-line, treatments for bipolar disorder fail. What is Treatment Resistance? There is no consensus among clinicians and researchers on one definition of treatment resistance. Generally, patients in an acute state (manic, depressed or mixed) whose symptoms do not improve after at least two evidence-based medication trials are considered treatment-resistant in research studies. In the maintenance phase, patients are considered treatment-resistant if they continue cycling despite several adequate medication trials. In some studies additional criteria must be met in order to truly be considered treatment-resistant. These include functional measures of remission. Dr. Prakash Masand, psychiatrist and founder of Global Medical Education argues, however, that “Treatment-resistance is more common than most clinicians think since a sustained response to treatment rarely includes an assessment of functioning. When functioning ...
Source: Psych Central - Category: Psychiatry Authors: Tags: Anticonvulsants Antidepressants Atypical Antipsychotics Bipolar Cognitive-Behavioral Disorders General Medications Mood Stabilizers Psychotherapy Treatment Abilify Aripiprazole Bipolar Disorder Clinicians Consensus Depakote Source Type: news

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Medication, Therapy, Hospitalization, Electroconvulsive Therapy- what are the treatment strategies for schizophrenia? How do you convince someone they need help? What if someone refuses treatment? Schizophrenic Rachel Star Withers with co-host Gabe Howard reveal different treatments they have undergone over the years with various outcomes. Guest Barbara Thompson, with the National Alliance on Mental Illness, shares support options for people with schizophrenia and their family in the community. Highlights from “Treatment Strategies for Schizophrenia” Episode [02:00] How to bring up Schizophrenia to a loved one ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Caregivers Inside Schizophrenia Mental Health and Wellness Podcast Psychiatry Psychology Treatment Electroconvulsive Therapy getting help Living With Schizophrenia Mental Disorder Mental Illness Support Group Treatment For Schizo Source Type: blogs
Conclusion: This case represents an example of diagnostic and therapeutic challenges of catatonic schizophrenia in high-functioning autism due to clinical and neurobiological overlaps of these conditions. We discuss clinical features together with pathophysiological concepts of both conditions. Furthermore, we tackle social and legal hurdles in Germany that naturally arise in these patients. Finally, we present diagnostic “red flags” that can be used to rationally select and conduct current recommended diagnostic assessments if there is a suspicion of ASD in patients with catatonic syndrome in order to provide ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This study will be conducted in the city of Porto Alegre in the state of Rio Grande do Sul in far-southern Brazil. This region has Portuguese, Italian, German, and African influence. It has a population of 1.4 million, and it is the 10th most populous city in Brazil. Its ethnic distribution is as follows: White (79.2%), Black (10.2%), and Pardo (multiracial) people (10.6%). Its religious distribution is as follows: Catholic (83%), Protestant (9%), and others and atheists (8%). Brazil is a country with a high level of religiosity, and it is common for people to associate improvements in their health as being due to their fa...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Depression affects 450 million people worldwide and 15 million adults in the United States (U.S.) alone. Suicide is the 10th leading cause of death in the United States, claiming over 40,000 lives every year. We see these heartbreaking stories making headlines too often, and there are tens of thousands more we do not know about. The scariest part? There is no end in sight. Antidepressants are one of the three most commonly used therapeutic drug classes in the United States. Approximately 1 in 9 Americans of all ages reported taking at least one antidepressant medication — a number that was less than 1 in 50 just th...
Source: Psych Central - Category: Psychiatry Authors: Tags: Antidepressants Bipolar Depression Medications Mood Stabilizers Neuroscience Suicide Treatment Deep brain stimulation Deep transcranial magnetic stimulation Depression Treatment Electroconvulsive Therapy Major Depressive Disorder Source Type: news
In this issue of the journal, 2 case reports are presented that illustrate explicit influences of structural brain lesions on psychiatric symptoms. In both cases, the patients had preexisting, classically diagnosed psychiatric disorders—schizophrenia in the first case and bipolar I disorder in the second case. In the first case, a 61-year-old woman with chronic paranoid schizophrenia experienced a marked reduction in psychotic symptoms after bilateral frontal strokes. In the second case, a 60-year-old man who had experienced manic and depressive episodes since his 20s developed partial complex seizures after having r...
Source: Journal of Psychiatric Practice - Category: Psychiatry Tags: Clinical Case Discussions Source Type: research
Within 24 hours of her second daughter’s birth, Dyane Harwood felt elated. From the moment she came home from the hospital, she started writing. Furiously. She wrote while nursing her daughter and going to the bathroom. She wrote on her hands, on the bathroom mirror, inside books and on tabletops. She yearned to write down every thought she was having. She wrote so much that her wrists ached—her carpal tunnel returning—and she was in constant pain. She also had endless energy and a newfound enthusiasm for life. She felt like she could run a long race. She couldn’t sit still, and her speech was fast ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Bipolar Disorders General Health-related Mental Health and Wellness Self-Help Sleep Women's Issues Johns mood disorder Motherhood Parenting postpartum bipolar disorder postpartum depression Postpartum Disorder Source Type: blogs
Depression is the leading cause of disability in the United States among people ages 15 to 44. While there are many effective treatments for depression, first-line approaches such as antidepressants and psychotherapy do not work for everyone. In fact, approximately two-thirds of people with depression don’t get adequate relief from the first antidepressant they try. After 2 months of treatment, at least some symptoms will remain for these individuals, and each subsequent medication tried is actually less likely to help than the one prior. What can people with depression do when they do not respond to first-line treat...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Anxiety and Depression Behavioral Health Brain and cognitive health Mental Health Source Type: blogs
CONCLUSIONS: Use of ECT is exceptionally uncommon and limited to patients with extensive multimorbidity and high levels of service use. ECT utilization is most limited in areas of the country where regulatory restrictions are greatest. PMID: 29385954 [PubMed - as supplied by publisher]
Source: Psychiatric Services - Category: Psychiatry Tags: Psychiatr Serv Source Type: research
Despite its effectiveness in treating severe depression, the use of electroconvulsive therapy (ECT) is “exceptionally uncommon and limited to patients with extensive multimorbidity,” according to areport published Thursday inPsychiatric Services in Advance.Samuel Wilkinson, M.D., of Yale School of Medicine and colleagues compared the sociodemographic and clinical characteristics of privately insured Americans with major depressive or bipolar disorder who received ECT and those who did not.The authors found that among the selected individuals in the 2014 MarketScan commercial insurance claims database (N=47,258,...
Source: Psychiatr News - Category: Psychiatry Tags: bipolar disorder ECT electroconvulsive therapy MarketScan Psychiatric Services in Advance Samuel Wilkinson stigma treatment-resistant depression Source Type: research
Adjunctive vagus nerve stimulation (VNS) can lead to better five-year clinical outcomes in patients with chronic, treatment-resistant depression, reports astudy published March 31 inAJP in Advance.These findings provide the first long-term evidence of the benefits of VNS.VNS, which involves delivering electrical impulses to the vagus nerve via an implanted generator, was approved for treatment-resistant depression in 2005. As part of the approval, the Food and Drug Administration required a postmarketing surveillance study, which led to the formation of the Treatment-Resistant Depression Registry. ...
Source: Psychiatr News - Category: Psychiatry Tags: depression ECT electroconvulsive therapy registry treatment resistant depression vagus nerve stimulation VNS Source Type: research
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