Pharmacological management of bipolar disorder: Japanese expert consensus

Autor:	Takefumi Suzuki, Ikuko Kishida, Masaki Kato, Hiroyuki Uchida, Koichiro Watanabe, Yuka Sugawara Kikuchi, Hitoshi Sakurai, Asuka Katsuki, Toshiaki Kikuchi, Norio Yasui-Furukori, Hajime Baba, Ken Inada
Rok vydání:	2020
Předmět:	medicine.medical_specialty Bipolar Disorder Consensus Lithium (medication) medicine.drug_class medicine.medical_treatment Atypical antipsychotic Lithium Treatment of bipolar disorder 03 medical and health sciences 0302 clinical medicine Japan Internal medicine Humans Medicine Bipolar disorder Antipsychotic Adverse effect Biological Psychiatry business.industry Original Articles medicine.disease Antidepressive Agents 030227 psychiatry Neuropsychopharmacology Psychiatry and Mental health Antidepressant Original Article Drug Therapy Combination Female business 030217 neurology & neurosurgery Antipsychotic Agents medicine.drug
Zdroj:	Bipolar Disorders
ISSN:	1399-5618 1398-5647
DOI:	10.1111/bdi.12959
Popis:	Objectives The aim of this study was to develop a consensus guideline by certified experts of the Japanese Society of Clinical Neuropsychopharmacology on the psychopharmacological treatment for bipolar disorders I and II (BP‐I and BP‐II), in order to fill the gap in the literature and provide more concrete guidance for challenging and controversial real‐world situations. Methods Experts were asked to assess treatment options regarding 19 clinical situations of bipolar disorder with a nine‐point Likert scale (one = “disagree” and nine = “agree”). According to the responses from 119 experts, the options were categorized into the first‐, second‐, and third‐line treatments. Results For the treatment of BP‐I, lithium monotherapy was categorized as a first‐line treatment for manic episodes (mean ± standard deviation score, 7.0 ± 2.2), depressive episodes (7.1 ± 2.0), and the maintenance phase (7.8 ± 1.8). Combination therapy of lithium and an atypical antipsychotic was endorsed for manic episodes (7.7 ± 1.7), depressive episodes with (7.1 ± 2.0) and without mixed features (6.9 ± 2.2), and the maintenance phase (6.9 ± 2.1). Similarly, in BP‐II, lithium monotherapy was categorized as a first‐line treatment for hypomanic episodes (7.3 ± 2.2), depressive episodes (7.0 ± 2.2), and the maintenance phase (7.3 ± 2.3), while combination therapy of lithium and an atypical antipsychotic was recommended for hypomanic episodes (6.9 ± 2.4).No antipsychotic monotherapy or antidepressant treatment was categorized as a first‐line treatment for any type of episode. Conclusions These recommendations reflect the current evidence and represent the experts' consensus on using lithium for the treatment of bipolar disorder. Clinicians should consider the effectiveness and adverse effects of antipsychotic and antidepressant medications for the treatment of bipolar disorder.
Databáze:	OpenAIRE
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