Pharmacological |
|
Aripiprazole |
Partial agonist of D2, D3, D4, 5-HT1A, 5-HT2C, and 5-HT7 receptors3131. Sugawara H, Sakamoto K, Harada T, Shimizu S, Ishigooka J. A retrospective study of predictive factors for effective aripiprazole augmentation of antidepressant therapy in treatment-resistant depression. Neuropsychiatr Dis Treat. 2016;12:1151-6. |
D-cycloserine |
Partial agonist at the glycine recognition of the NMDA receptor3535. Chen MH, Cheng CM, Gueorguieva R, Lin WC, Li CT, Hong CJ, et al. Maintenance of antidepressant and antisuicidal effects by D-cycloserine among patients with treatment-resistant depression who responded to low-dose ketamine infusion: a double-blind randomized placebo-control study. Neuropsychopharmacology. 2019;44:2112-8. |
Ketamine |
NMDA receptor antagonist3434. Diazgranados N, Ibrahim L, Brutsche NE, Newberg A, Kronstein P, Khalife S, et al. A randomized add-on trial of an N-methyl-D-aspartate antagonist in treatment-resistant bipolar depression. Arch Gen Psychiatry. 2010;67:793-802. |
Lurasidone |
Antagonist of 5-HT2A, 5-HT7, and D2 receptors, agonist of 5-HT1A receptor2828. Loebel A, Cucchiaro J, Silva R, Kroger H, Sarma K, Xu J, et al. Lurasidone as adjunctive therapy with lithium or valproate for the treatment of bipolar I depression: a randomized, double-blind, placebo-controlled study. Am J Psychiatry. 2014;171:169-77. |
AT1R blocker |
Modulator of the renin-angiotensin system4343. Vian J, Pereira C, Chavarria V, Kohler C, Stubbs B, Quevedo J, et al. The renin-angiotensin system: a possible new target for depression. BMC Med. 2017;15:144. |
Minocycline |
Anti-microbial with anti-inflammatory and neuroprotective properties3636. Savitz JB, Teague TK, Misaki M, Macaluso M, Wurfel BE, Meyer M, et al. Treatment of bipolar depression with minocycline and/or aspirin: an adaptive, 2x2 double-blind, randomized, placebo-controlled, phase IIA clinical trial. Transl Psychiatry. 2018;8:27. |
Pioglitazone |
Selective PPAR-γ agonist with anti-inflammatory properties3838. Aftab A, Kemp DE, Ganocy SJ, Schinagle M, Conroy C, Brownrigg B, et al. Double-blind, placebo-controlled trial of pioglitazone for bipolar depression. J Affect Disord. 2019;245:957-64. |
N-acetylcysteine |
Decreases the oxidative stress caused by ROS through glutathione regulation4242. Fernandes BS, Dean OM, Dodd S, Malhi GS, Berk M. N-Acetylcysteine in depressive symptoms and functionality: a systematic review and meta-analysis. J Clin Psychiatry. 2016;77:e457-66. |
Non-pharmacological |
|
Non-invasive |
|
Deep TMS |
Over the left dorsolateral PFC5252. Tavares DF, Myczkowski ML, Alberto RL, Valiengo L, Rios RM, Gordon P, et al. Treatment of bipolar depression with deep tms: results from a double-blind, randomized, parallel group, sham-controlled clinical trial. Neuropsychopharmacology. 2017;42:2593-601. |
iTBS |
Over the left dorsolateral PFC5151. Bulteau S, Beynel L, Marendaz C, Dall'Igna G, Pere M, Harquel S, et al. Twice-daily neuronavigated intermittent theta burst stimulation for bipolar depression: a randomized sham-controlled pilot study. Neurophysiol Clin. 2019;49:371-5. |
Magnetic seizure therapy |
Over the bilateral PFC or the vertex5050. Tang VM, Blumberger DM, Dimitrova J, Throop A, McClintock SM, Voineskos D, et al. Magnetic seizure therapy is efficacious and well tolerated for treatment-resistant bipolar depression: an open-label clinical trial. J Psychiatry Neurosci. 2020;45:313-21. |
Invasive |
|
DBS |
Bilateral subcallosal cingulate white matter6060. Holtzheimer PE, Kelley ME, Gross RE, Filkowski MM, Garlow SJ, Barrocas A, et al. Subcallosal cingulate deep brain stimulation for treatment-resistant unipolar and bipolar depression. Arch Gen Psychiatry. 2012;69:150-8. |
VNS therapy |
Vagus nerve5555. Aaronson ST, Sears P, Ruvuna F, Bunker M, Conway CR, Dougherty DD, et al. A 5-year observational study of patients with treatment-resistant depression treated with vagus nerve stimulation or treatment as usual: comparison of response, remission, and suicidality. Am J Psychiatry. 2017;174:640-8. |