. Author manuscript; available in PMC: 2025 Feb 1.

Published in final edited form as: Bipolar Disord. 2023 Nov 14;26(1):7–21. doi: 10.1111/bdi.13383

Table 2 -.

Proposed Definition of Treatment-Resistant Mania (TRM)

Mania severity criteria	Mania duration criteria	Treatment criteria: type of treatment	Treatment criteria: dosage and duration
- DSM-5 criteria for a manic episode - YMRS ≥18 or MRS ≥13	Episode lasting six weeks or longer	Persistent manic episode despite treatment with at least one traditional mood stabilizer and one antipsychotic (sequentially or concurrently)	Therapeutic blood levels or dosage established in registration trials for at least three weeks for each treatment trial

DSM-5: Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition; MRS: Mania Rating Scale; YMRS: Young Mania Rating Scale