Medication For Treatment Resistant Bipolar Disorder

Often finding a medication that is effective, has minimal side effects, and works for a patient with bipolar depression is one of our greatest challenges. Lurasidone trade name being Latuda seems to be one of those newer medications that we can use with our patients who might not otherwise respond well to the current or previous medications available. This is a very good addition to the sparse repertoire of previous medications that were approved for acute bipolar depression. The typical treatments were the augmentation of olanzapine and fluoxetine, or quetiapine.

Medications for Bipolar Treatment are Limited

There has been a great need for a medication that would help people with bipolar depression. Depressive episodes occur 68 % of the time and manic episodes occur 32% of the time. This depressive state is also the most debilitating along with the mixed state (mania combined with depression) for a patient to be in due to the life-threatening suicidal ideas or relationship and or employment-threatening symptoms patients have in this state and where there is a high risk of need for psychiatric hospitalization. If a patient is ever suicidal, they will receive lithium in the ER which immediately takes away the suicidal ideas.

More Effective Treatment

Lurasidone, has been a welcomed addition to the available medication that can be effective both alone as a monotherapy treatment, or when it is added to valproate or lithium, as an adjunct therapy. Lurasidone has fewer side effects with a lower risk of weight gain, increased blood pressure, or an increased risk of increased blood glucose levels and cholesterol. These problems have sometimes made the older therapies virtually intolerable to many patients. There also seems to be, from what I have seen clinically, a lower sedative effect, which can be very helpful especially in those depressed patients who are already fatigued; and we don’t want to add that during the day if that can at all be avoided. TMS and ketamine have been working well for bipolar depression. Possible even DBS.