NYMC Faculty Publications
The American Society of Clinical Psychopharmacology Survey of Psychopharmacologists' Practice Patterns for the Treatment of Mood Disorders
DOI
10.1002/da.22378
Journal Title
Depression and Anxiety
First Page
605
Last Page
613
Document Type
Article
Publication Date
8-1-2015
Department
Psychiatry and Behavioral Sciences
Keywords
Antidepressive Agents, Antipsychotic Agents, Female, Health Care Surveys, Humans, Male, Middle Aged, Mood Disorders, Practice Patterns, Physicians', Psychopharmacology, Societies, Medical, United States
Disciplines
Medicine and Health Sciences
Abstract
BACKGROUND: Optimal successive treatment decisions are not well established after an initial medication nonresponse in major depressive disorder or bipolar disorder. While practice guidelines offer consensus-based expert treatment recommendations, little is known about "real world" pharmacology decision making by practicing psychopharmacologists.
MATERIALS AND METHODS: We surveyed via Internet the national membership of the American Society of Clinical Psychopharmacology (ASCP) to study preferred pharmacotherapy strategies and factors that influence medication choices for patients with mood disorders.
RESULTS: Surveys were returned by 154/752 ASCP members (21%). After nonresponse to a serotonin reuptake inhibitor in major depressive disorder, participants equally favored switching within or across antidepressant classes. After a partial response, adjunctive bupropion was the preferred intervention, followed by changing antidepressant classes. Atypical antipsychotic augmentation was only a fourth-line consideration, even though moderate or marked efficacy was perceived in most instances with olanzapine, aripiprazole, and quetiapine. Respondents favored avoiding antidepressants in bipolar I patients with mixed/cycling features or prior antidepressant-associated mania/hypomania. In rapid cyclers, they advocated antidepressant cessation and preferred the use of atypical antipsychotics and lamotrigine.
CONCLUSIONS: Participating psychopharmacologists treating adults with mood disorders report prescribing medications that largely mirror the evidence base with only a few notable exceptions, in consideration of the characteristics of definable clinical subpopulations.
Recommended Citation
Goldberg, J., Freeman, M., Balon, R., Citrome, L., Thase, M., Kane, J., & Fava, M. (2015). The American Society of Clinical Psychopharmacology Survey of Psychopharmacologists' Practice Patterns for the Treatment of Mood Disorders. Depression and Anxiety, 32 (8), 605-613. https://doi.org/10.1002/da.22378
