King's College London

Research portal

The CINP guidelines on the definition and the evidence-based interventions for treatment-resistant Bipolar disorder

Research output: Contribution to journalArticle

Konstantinos N Fountoulakis, Lakshmi Yatham, Heinz Grunze, Eduard Vieta, Allan Young, Pierre Blier, Mauricio Tohen, Siegfried Kasper, Hans Jurgen Moeller

Original languageEnglish
JournalInternational Journal of Neuropsychopharmacology
Publication statusE-pub ahead of print - 5 Dec 2019

Bibliographical note

© The Author(s) 2019. Published by Oxford University Press on behalf of CINP.


  • bipolar resistant treatment

    bipolar_resistant_treatment.docx, 617 KB, application/vnd.openxmlformats-officedocument.wordprocessingml.document


    Submitted manuscript

King's Authors


INTRODUCTION: Resistant Bipolar disorder (BD) is a major mental health problem related to significant disability and overall cost. The aim of the current study was to perform a systematic review of the literature concerning a) the definition of treatment resistance in BD, b) its clinical and c) neurobiological correlates, and d) the evidence-based treatment options for treatment resistant BD and eventually to develop guidelines for the treatment of this condition.

MATERIAL AND METHODS: The PRISMA method was used to identify all published papers relevant to the definition of treatment resistance in BD and the associated evidence-based treatment options. The MEDLINE was searched to April 22nd, 2018.

RESULTS: Criteria were developed for the identification of resistance in BD concerning all phases. The search of the literature identified all published studies concerning treatment options. The data were classified according to strength and separate guidelines concerning resistant acute mania, acute bipolar depression and the maintenance phase were developed.

DISCUSSION: The definition of resistance in BD is by itself difficult due to the complexity of the clinical picture, course and treatment options. The current guidelines are the first developed specifically for the treatment of resistant BD patients and they also include an operationalized definition of treatment resistance. They were based on a thorough and deep search of the literature.and utilize as much as possible an evidence-based approach.

View graph of relations

© 2018 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454