AGREE vurderinger af guidelines NKR for medicinsk vedligeholdelsesbehandling af bipolar lidelse

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1 AGREE vurderinger af guidelines NKR for medicinsk vedligeholdelses af bipolar lidelse Titel Evidence-based guidelines for treating bipolar disorder: revised second edition-- recommendations from the British Association for Psychopharmacology () 2009 NCCMH. Bipolar Disorder: the Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care NICE (2) Fokuserede spørgsmål Population Intervention Comparison Outcome Effektparameter Voksne med bipolar lidelse Vedligeholdelses Gravide Ældre Misbrug Voksne og børn med bipolar lidelse Vedligeholdelses :? :? Bl. Tilstand:? Vedligehold: relapse Angivet forskelligt for hvert præparat, fase Relapse, symptom levels, indlæggelse, tolerabilitet, diskontinuation, bivirkninger m.m. Defineret på forhånd AGREE MK/ERL/KM 59% 39% 40% 67% 8% 4% OA: 44% anvendes med modifikationer: 2 PD/KSC/KM 96% 94%

2 2006 Gravide 49% 64% OA: The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 202 on the longterm treatment of bipolar disorder (3) 202 Voksne (og børn/ældre hvor evidens var tilgængelig) med bipolar lidelse Vedligeholdelses Hormoner, vitaminer, FFA, aminosyrer Treatment emergent episode (TEE), sikkerhed, tolerabilitet Anvendes: 2 Anvendes med modifikationer: MV/KM 39% 60% 78% 27% 67% OA: 58% Anvendes: Nasjonal fagleg Børn, unge og voksne med Ikke klart defineret

3 retningslinje for utgreiing og av bipolare lidingar (4) 202 bipolar lidelse Hypomani Vedligeholdelses Gravide Ældre Psykisk udviklingshæmmede Psykiatrisk komorbiditet og misbrug på forhånd. PEH/MK/KM 70% 8% 48% 80% 57% 94% OA: 39% Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 203 (5) Børn, unge og voksne med bipolar lidelse Vedligeholdelses Blandingstilstand Graviditet Ældre Symptom sværhedsgrad, discontinuation, remissionsrate, relapse m.m. Varierende angivet for hvert præparat og fase Anvendes med forbehold: 2 MV/KSC/KM 69% 3% 5% 8% 5%

4 203 The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 200 on the treatment of acute bipolar depression (6) 200 Voksne med bipolar lidelse Psykotiske symptomer Symptom scores, sikkerhed Varierende angivet for hvert præparat 44% OA: 44% Anvendes med forbehold: 2 PEH/ERL/KM 69% 28% 76% 9% 33% OA: 44% The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological Voksne (og unge/ældre hvor evidens var tilgængelig) med bipolar lidelse Symptom scores, angivet varierende for hvert præparat Anvendes: 2 PD/(GH)/KM 75%

5 treatment of bipolar disorders: update 2009 on the treatment of acute mania (7) 2009 Blandingstilstand (Hypomani) Psykotiske symptomer 36% 58% 78% 27% 67% OA: 67% Anvendes:

6 Referencer () Goodwin GM, Consensus Group of the British Association for Psychopharmacology. Evidence-based guidelines for treating bipolar disorder: revised second edition--recommendations from the British Association for Psychopharmacology. J Psychopharmacol 2009 Jun;23(4): (2) National Institute for Health and Care Excellence. Bipolar disorder: The management og bipolar disorder in adults, children and adolescents, in primary and secondary care. 2006;CG38. (3) Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller H-, et al. The world federation of societies of biological psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: Update 202 on the long-term treatment of bipolar disorder. World J Biol Psychiatry 203 /;4(3): (4) Helsedirektoratet. Nasjonal fagleg retningslinje for utgreiing og av bipolare lidingar (5) Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 203. Bipolar Disord 203 Feb;5():-44. (6) Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for the Biological Treatment of Bipolar Disorders: Update 200 on the treatment of acute bipolar depression. World J Biol Psychiatry 200 Mar;(2):8-09. (7) Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, Moller HJ, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2009 on the treatment of acute mania. World J Biol Psychiatry 2009;0(2):85-6.