Incorporating Clinical Trial Data Into Bipolar Disorder Management
Terence A. Ketter, MD
Forgot your login? GET HELP
Evidence-based medicine integrates data from clinical trials into clinical care while efficacy studies assess simplified interventions in simplified populations. The findings of such studies are useful in obtaining Food and Drug Administration approval of medications but often fail to generalize to the more complex populations and interventions commonly seen in clinical practice. Recently, an increased emphasis has been placed on effectiveness studies (also referred to as pragmatic or practical studies) designed to yield findings that can be generalized to the clinical management of patients with bipolar disorder. Mood stabilizers and increasingly second-generation antipsychotics are considered the foundation of treatment for bipolar disorder. In contrast, adjunctive antidepressants should be avoided when patients present with manic and mixed episodes. Additional interventions—such as psychoeducation and care coordination—when combined with pharmacotherapy, can lessen the frequency and severity of mood episodes, especially mania. These interventions, combined with judicious pharmacotherapy, can help minimize the impact of adverse effects and related nonadherence so that patients can achieve affective stability, regain psychosocial function, and maintain health.
See the entire activity.
J Clin Psychiatry 2008;69(7):e21
© Copyright 2008 Physicians Postgraduate Press, Inc.
Manage Subscriptions
/_layouts/images/ReportServer/Manage_Subscription.gif
/JCP/article/_layouts/ReportServer/ManageSubscriptions.aspx?list={ListId}&ID={ItemId}
0x80
0x0
FileType
rdl
350
Manage Data Sources
/JCP/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rdl
351
Manage Shared Datasets
/JCP/article/_layouts/ReportServer/DatasetList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rdl
352
Manage Parameters
/JCP/article/_layouts/ReportServer/ParameterList.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
353
Manage Processing Options
/JCP/article/_layouts/ReportServer/ReportExecution.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
354
Manage Cache Refresh Plans
/JCP/article/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
355
View Report History
/JCP/article/_layouts/ReportServer/ReportHistory.aspx?list={ListId}&ID={ItemId}
0x0
0x40
FileType
rdl
356
View Dependent Items
/JCP/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsds
350
Edit Data Source Definition
/JCP/article/_layouts/ReportServer/SharedDataSource.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsds
351
View Dependent Items
/JCP/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
350
Manage Clickthrough Reports
/JCP/article/_layouts/ReportServer/ModelClickThrough.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
352
Manage Model Item Security
/JCP/article/_layouts/ReportServer/ModelItemSecurity.aspx?list={ListId}&ID={ItemId}
0x0
0x2000000
FileType
smdl
353
Regenerate Model
/JCP/article/_layouts/ReportServer/GenerateModel.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
smdl
354
Manage Data Sources
/JCP/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
smdl
351
Load in Report Builder
/JCP/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderModelContext&list={ListId}&ID={ItemId}
0x0
0x2
FileType
smdl
250
Edit in Report Builder
/_layouts/images/ReportServer/EditReport.gif
/JCP/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderReportContext&list={ListId}&ID={ItemId}
0x0
0x4
FileType
rdl
250
Edit in Report Builder
/JCP/article/_layouts/ReportServer/RSAction.aspx?RSAction=ReportBuilderDatasetContext&list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
250
Manage Caching Options
/JCP/article/_layouts/ReportServer/DatasetCachingOptions.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
350
Manage Cache Refresh Plans
/JCP/article/_layouts/ReportServer/CacheRefreshPlanList.aspx?list={ListId}&ID={ItemId}&IsDataset=true
0x0
0x4
FileType
rsd
351
Manage Data Sources
/JCP/article/_layouts/ReportServer/DataSourceList.aspx?list={ListId}&ID={ItemId}
0x0
0x20
FileType
rsd
352
View Dependent Items
/JCP/article/_layouts/ReportServer/DependentItems.aspx?list={ListId}&ID={ItemId}
0x0
0x4
FileType
rsd
353
Compliance Details
javascript:commonShowModalDialog('{SiteUrl}/_layouts/itemexpiration.aspx?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/hold.aspx?ID={ItemId}&List={ListId}'); return false;} if(pageid == 'audit') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/Reporting.aspx?Category=Auditing&backtype=item&ID={ItemId}&List={ListId}'); return false;} if(pageid == 'config') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+'/_layouts/expirationconfig.aspx?ID={ItemId}&List={ListId}'); return false;}}, null); return false;
0x0
0x1
ContentType
0x01
898
Document Set Version History
javascript:SP.UI.ModalDialog.ShowPopupDialog('{SiteUrl}/_layouts/DocSetVersions.aspx?List={ListId}&ID={ItemId}')
0x0
0x0
ContentType
0x0120D520
330
Send To other location
javascript:GoToPage('{SiteUrl}/_layouts/docsetsend.aspx?List={ListId}&ID={ItemId}')
0x0
0x0
ContentType
0x0120D520
350