treatment resistance Archives - Natasha Tracy Bipolar Expert

Dextromethorphan Vs Ketamine: A New (Affordable) Depression Treatment Option Explained

Posted by Natasha Tracy | Oct 17, 2024

Looking for a more affordable alternative to ketamine for treatment-resistant depression? Discover how dextromethorphan/bupropion offers new hope. This article breaks down the differences between ketamine and dextromethorphan, their effectiveness, and how these antidepressants work. If you’ve struggled with depression treatments or face challenges accessing expensive therapies like ketamine, this guide might offer the answers you’ve been searching for. Dive in to learn more about this innovative approach.

When the Bipolar Medication Isn’t Working — Treatment-Resistant Bipolar Disorder

Posted by Natasha Tracy | Nov 9, 2023

I have spent years of my life with bipolar medication not working — or, at least, bipolar medication not working to the extent that one would want. I know this isn’t the common refrain around medication — the common refrain being, take bipolar medication and get better — but it is a reality that many of us live with. So, the question is, what do you do when the bipolar medication isn’t working? What do you do when you have treatment-resistant bipolar disorder?

What to Do When Your Doctor Can’t Help You

Posted by Natasha Tracy | Sep 21, 2023

I know what it feels like when your doctor says they can’t help you. I’ve had this happen many times. I’ve experienced everything from being fired by a doctor to having a doctor deny me care altogether. These are rough things. Any time your doctor says they can’t help you, it’s tough to take. But there are things you can do, even at that point. Here’s what to do when your doctor says they can’t help you.

New Treatments for Bipolar Depression—Options for Treatment Resistance

Posted by Natasha Tracy | Dec 14, 2022

Recently, Psychiatric Times did a comprehensive piece on new or unusual bipolar depression treatments, treatments that may be an option for treatment-resistant bipolar depression. They are thinking outside the standard bipolar depression treatments. This is critical because many people just aren’t being helped or aren’t being helped enough by standard bipolar depression treatments. These novel bipolar depression treatments come in two flavors: medication-based and non-medication-based. If you’re at a place in your bipolar depression treatment where you’re not getting better, you may want to consider discussing these unique treatments with your psychiatrist.

Antipsychotics Should Be Used for Non-Psychotic Depression Treatment

Posted by Natasha Tracy | Feb 6, 2017

While some disagree, it’s important that people understand that antipsychotics need to be used for non-psychotic depression treatment, when appropriate.

At any one time, 14 million people suffer from depression but only 60-70% of these people respond to antidepressant treatment. Of those who do not respond, 10-30% exhibit treatment-resistant symptoms including “difficulties in social and occupational function, decline of physical health, suicidal thoughts, and increased health care utilization.” Treating these people presents a huge issue for healthcare practitioners and one of the options they consider is the use of a medication class known as antipsychotics.

Recently, a group called the Therapeutics Initiative wrote a letter entitled Antipsychotics should not be used for non-psychotic depression. Their conclusions are as the title suggests: this body found little evidence to support the use of antipsychotics in the treatment of non-psychotic major depressive disorder.

And while I respect the work of this body and while they have considered some evidence (in the case of quetiapine [Seroquel], an antipsychotic), there is more to consider on the issue.

What Keeps a Person Sick with Bipolar Going When Treatment Doesn’t Work?

Posted by Natasha Tracy | May 13, 2014

Some people with bipolar disorder are lucky in that when they get treatment, they find something that works for them within some reasonable period of time (and this might be in a year or two, maybe not altogether reasonable, but on the whole, good). However, not all people sick with bipolar are so lucky. Some people with acute bipolar symptoms don’t find anything that works for them for prolonged periods of time. In fact, for many people sick with bipolar, it seems like they will never find any treatment that will work.

So if you’re in this latter group (and I am) what keeps you going? If you still suffer from acute bipolar symptoms and the treatment isn’t working, how do you keep trying to get better, day after day?

We Must Aim for Zero Bipolar Symptoms During Treatment

Posted by Natasha Tracy | Apr 21, 2014

Raise the Bar on Bipolar Treatment – Hold Your Doctor to Task

Let me be honest. Even when my treatment is at its best, I never get to the place of zero bipolar symptoms. I’m well, I can handle the remaining symptoms with coping skills, I can be happy but there are always lingering symptoms of bipolar disorder.

And this may be an indicator of being difficult to treat because what we know is that the more you can successfully treat all the symptoms of bipolar disorder, the more likely you are to have fewer relapses. In other words, if you continue to experience bipolar symptoms during treatment, you’re more likely to experience future episodes and we really want to avoid that as each future episode tends to make your bipolar harder to treat.

For this reason, it’s critical to aim for zero bipolar symptoms during treatment, whenever possible.

Truehope and the Bipolar “Treatment” EMPowerplus

Posted by Natasha Tracy | Dec 9, 2013

I have been wanting to write about the Truehope people (makers of EMPowerplus) for years but I haven’t because, well, I didn’t have anything nice to say, so I didn’t say anything at all. I knew that any critique I made of these people would be met with a slew of hate mail and, really, I get enough of that already.

But now I’m ready to go and at the bottom I’ll tell you why.

Hope for Treatment-Resistant Bipolar Depression

Posted by Natasha Tracy | Jun 17, 2013

Recently, I wrote a piece for PsychCentral that outlined some recommendations for treatment-resistant bipolar disorder. This piece talked about first-line and second-line agents for the treatment of bipolar disorder but I wanted to delve a little further into the novel agents that are now being studied for the treatment of bipolar depression. These are medications that are not typically used to treat bipolar disorder, work in new ways and show promise in recent studies. This is cutting edge and if you’re treatment-resistant this is an area that can offer you hope.

Why Are Novel Agents Needed in the Treatment of Bipolar Depression?

The reason why this piece is about unusual bipolar depression medication and not medication for mania is because the medications we have for mania are quite effective for most people. It is the bipolar depression that, typically, is very hard to treat. Additionally the two Food and Drug Administration (FDA)-approved bipolar depression treatments (quetiapine and an olanzapine/fluoxetine combination) tend to carry very serious side effects like weight gain, risk of diabetes including diabetic ketoacidosis and others. We also know that most people with bipolar disorder spend vastly more time in a depressed state than in a manic state.

According to Dr. Prakash Masand, CEO and founder of Global Medical Education, “Less than 30% of bipolar patients achieve remission that is maintained long term. There are great unmet needs in the treatment of bipolar depression. Innovative approaches are needed rather than ‘me-too’ agents that offer little incremental benefit.”

Dr. Masand notes the following are new, novel agents that look promising in the treatment of bipolar depression.