Report of the Texas Consensus Conference Panel on Medication Treatment of Bipolar Disorder 2000
J Clin Psychiatry 2002;63(4):288-299
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The process and outcome of
a consensus conference to develop revised algorithms for treatment of bipolar disorder to
be implemented in the public mental health system of Texas are described. These medication
algorithms for bipolar disorder are an update of
those developed for the Texas Medication Algorithm Project, a research study that tested the
clinical and economic impact of treatment guidelines
for major psychiatric illnesses treated in the
Texas public mental health system (Texas
Department of Mental Health and Mental Retardation [TDMHMR]).
Method: Academic clinicians and
researchers, practicing clinicians in the TDMHMR
system, administrators, advocates, and consumers
participated in a consensus conference in August 2000. Participants attended presentations
reviewing new evidence in the pharmacologic
treatment of bipolar disorder and discussed the needs
of consumers in the TDMHMR system. Principles were enumerated, including balancing of
evidence for efficacy, tolerability, and safety in medication choices. A set of 7 distinct
algorithms was drafted. In the following months, a
subcommittee condensed this product into 2 primary
Results: The panel agreed to 2 primary
algorithms: treatment of mania/hypomania,
including 3 pathways for treatment of euphoric
symptoms, mixed or dysphoric symptoms, and
psychotic symptoms; and treatment of depressive
symptoms. General principles to guide algorithm implementation were discussed and drafted.
Conclusion: The revised algorithms are
currently being disseminated and implemented within the Texas public mental health system.
The goals of the Texas initiative include increasing
the consistency of appropriate treatment of
bipolar disorder, encouraging systematic and optimal
use of available pharmacotherapies, and improving the outcomes of patients with bipolar disorder.