TREATMENT-RESISTANT BIPOLAR DEPRESSION

This article begins with a conceptual overview of treatment-resistant bipolar depression and discusses characteristics of bipolar illness an d factors that influence treatment outcome. The literature on treatmen ts for bipolar depression is reviewed, including topics such as antide pressant efficacy and treatment-emergent mania. Strategies are offered to improve clinical treatment outcome. Emphasis is placed on careful clinical assessment and prospective mood charting, and a treatment alg orithm that limits the use of standard antidepressant agents is presen ted.