Low-dose buspirone, melatonin and low-dose bupropion added to mood stabilizers for severe treatment-resistant bipolar depression.

摘要

Treatment-resistant bipolar depression that fails to improve with at least 2 evidence-based interventions presents a formidable challenge to clinicians without much data to guide treatment. I present the following case of treatment-resistant bipolar depression with a robust remission after treatment with the combination of buspirone 5 mg and melatonin 3 mg plus bupropion 75 mg added to lithium and lamotrigine (with prior failure of high-dose lithium and lamotrigine alone). To the best of my knowledge, this is the first case report of this combination for treatment-resistant bipolar depression. Part of the rationale for trying this was a report of the combination of low-dose bupropion and buspirone for treatment-resistant unipolar depression [1].