It is expected that practitioners will employ best practices in their prescribing habits as outlined by up-to-date expert evidence. The clinical practice guidelines (CPGs) are a reliable tool for assisting busy clinicians to do just that, since they provide recommendations about the best available treatments and may also provide information about non-recommended treatments that the CPGs designate as ineffective or unsafe. However, in reality, adherence to the CPGs is poor, which means that non-recommended treatments are often still used to treat bipolar disorder (BD). Throughout this chapter, we hope to provide clarity into the non-recommended treatments for BD. Using the results from a recent systematic review of CPGs, we summarized the non-recommended treatments for each phase of bipolar disorder, including mania, depression, maintenance, mixed features, and BD in special populations. Moreover, through discussion of the continued prescription of non-recommended treatments for BD, we hope to bring light to the issue of CPG non-adherence and address how we can promote clinician adherence.

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What Not to Use in the Pharmacological Treatment of Bipolar Disorder

  • Natalie Palma,
  • Fabiano Alves Gomes

摘要

It is expected that practitioners will employ best practices in their prescribing habits as outlined by up-to-date expert evidence. The clinical practice guidelines (CPGs) are a reliable tool for assisting busy clinicians to do just that, since they provide recommendations about the best available treatments and may also provide information about non-recommended treatments that the CPGs designate as ineffective or unsafe. However, in reality, adherence to the CPGs is poor, which means that non-recommended treatments are often still used to treat bipolar disorder (BD). Throughout this chapter, we hope to provide clarity into the non-recommended treatments for BD. Using the results from a recent systematic review of CPGs, we summarized the non-recommended treatments for each phase of bipolar disorder, including mania, depression, maintenance, mixed features, and BD in special populations. Moreover, through discussion of the continued prescription of non-recommended treatments for BD, we hope to bring light to the issue of CPG non-adherence and address how we can promote clinician adherence.