Bipolar disorder (BD) is highly prevalent, chronic and heterogeneous psychiatric disorder. Defining refractory bipolar disorder is a complex problem that involves every phase of the disorder and require more clear criteria and treatment modalities. Despite over expansion in BD pharmacotherapies in the last decade we still face difficulties in treating resistant cases. Securing long term mood stabilization for resistance cases, will improve the quality of life of these patients; who are euthymic only half of their life times according to observational studies.
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