Treatment Algorithm Use to Optimize Management of Symptomatic Patients With a History of Mania

Suppes, Trisha; Aj, Rush; Hc, Kraemer; Webb, Andrew

doi:10.4088/jcp.v59n0208

Cited by 14 publications

(22 citation statements)

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“…This study evaluated naturalistic prospective outcomes among individuals with bipolar disorder, while using the best practice procedures, or empirically based, guideline-informed treatment of bipolar disorder. 31 Thus, visits with participants’ treating physicians were not standardized across sites, but instead determined by the individual’s treatment goals and plan. Standard assessment visits were scheduled every 3 months during the first year of the study (and then every 6 months thereafter).…”

Section: Methodsmentioning

confidence: 99%

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Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder

Sylvia

Hay²,

Ostacher³

et al. 2013

Journal of Clinical Psychopharmacology

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Objectives We sought to understand the association of specific aspects of care satisfaction, such as patients’ perceived relationship with their psychiatrist and access to their psychiatrist and staff, and therapeutic alliance with participants’ likelihood to adhere to their medication regimens among patients with bipolar disorder. Methods We examined data from the multicenter Systematic Treatment Enhancement Program for Bipolar Disorder, an effectiveness study investigating the course and treatment of bipolar disorder. We expected that participants (n = 3037) with positive perceptions of their relationship with their psychiatrist and quality of psychopharmacologic care, as assessed by the Helping Alliance Questionnaire and Care Satisfaction Questionnaire, would be associated with better medication adherence. We utilized logistic regression models controlling for already established factors associated with poor adherence. Results Patients’ perceptions of collaboration, empathy, and accessibility were significantly associated with adherence to treatment in individuals with bipolar disorder completing at least 1 assessment. Patients’ perceptions of their psychiatrists’ experience, as well as of their degree of discussing medication risks and benefits, were not associated with medication adherence. Conclusions Patients’ perceived therapeutic alliance and treatment environment impact their adherence to pharmacotherapy recommendations. This study may enable psychopharmacologists’ practices to be structured to maximize features associated with greater medication adherence.

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Section: Methodsmentioning

confidence: 99%

“…32 To ensure individualized and optimized treatment, psychiatrists were trained on these expert consensus guidelines. 31 This study design allowed for naturalistic patient-provider interaction. Methods for the STEP-BD study are detailed elsewhere.…”

Section: Methodsmentioning

confidence: 99%

Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder

Sylvia

Hay²,

Ostacher³

et al. 2013

Journal of Clinical Psychopharmacology

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show abstract

“…mania with psychosis, atypical antipsychotic drug prescribed at moderate dose, mild side‐effects). Recommendations for specific clinical scenarios were based on treatment guidelines developed by the American Psychiatric Association (22), the Texas Medication Algorithms Project (23), and the Veterans Administration (2). For example, a scenario of moderate manic symptoms, use of lithium alone with a blood level of 0.5 and mild lithium side‐effects would lead to a recommendation to `Consider increasing dose of lithium.'…”

Section: Study Methodsmentioning

confidence: 99%

Design and implementation of a randomized trial evaluating systematic care for bipolar disorder

et al. 2002

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In a population-based sample of patients treated for bipolar disorder, approximately two-thirds agreed to participate in a randomized trial comparing alternative treatment strategies. Nearly all patients accepted regular telephone monitoring and over two-thirds joined a structured group program. Future reports will describe clinical effectiveness and cost-effectiveness of the intervention program compared with usual care.

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“…In addition, the lack of success of the first drug initiates a cascade of alternatives summarized in various algorithms (e.g. Suppes et al 1998). Conversely, however, if the doctor treats mania with a stimulant, there is the fear of worsening the disorder by exacerbating the mania or precipitating psychosis.…”

Section: Introductionmentioning

confidence: 99%

Stimulant Treatment in Young Boys with Symptoms Suggesting Childhood Mania: A Report from a Longitudinal Study

Carlson

Loney

Salisbury

et al. 2000

Journal of Child and Adolescent Psychopharmacology

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This study used data from a completed longitudinal study to examine the effects of methylphenidate on 6-12-year-old boys presumably at risk for bipolar disorder. Of 75 boys referred, diagnosed with hyperkinetic reaction of childhood (minimal brain dysfunction), treated clinically with methylphenidate, and followed as young adults, 23% (the maximorbid or MAX group) had childhood symptoms of irritability and emulated DSM-IV diagnoses of attention deficit hyperactivity disorder (ADHD), plus oppositional defiant or conduct disorder (ODD/CD) and anxiety or depression or both. The remaining boys (the minimorbid or MIN group) had fewer symptoms and disorders. MAX and MIN groups did not differ in rated response to methylphenidate, duration of treatment, clinically determined maintenance doses, concurrent or subsequent treatment with other medications, or other aspects of medication experience. At ages 21-23, individuals with bipolar-related lifetime diagnoses (adult mania, hypomania, or cyclothymia) did not differ from those without bipolar-related diagnoses in any aspect of early methylphenidate treatment history. These findings indicate that ADHD boys with symptoms suggesting childhood mania do not respond differently to methylphenidate than boys without such symptoms, and there is no evidence here that methylphenidate precipitates young adult bipolar disorders in susceptible individuals.

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Treatment Algorithm Use to Optimize Management of Symptomatic Patients With a History of Mania

Cited by 14 publications

References 0 publications

Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder

Association Between Therapeutic Alliance, Care Satisfaction, and Pharmacological Adherence in Bipolar Disorder

Design and implementation of a randomized trial evaluating systematic care for bipolar disorder

Stimulant Treatment in Young Boys with Symptoms Suggesting Childhood Mania: A Report from a Longitudinal Study

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