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Báo cáo y học: "Class effect of pharmacotherapy in bipolar disorder: fact or misbelief"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Class effect of pharmacotherapy in bipolar disorder: fact or misbelief? | Fountoulakis et al. Annals of General Psychiatry 2011 10 8 http www.annals-general-psychiatry.eom content 10 1 8 ANNALS OF GENERAL PSYCHIATRY REVIEW Open Access Class effect of pharmacotherapy in bipolar disorder fact or misbelief Konstantinos N Fountoulakis 1 Xenia Gonda2 3 Eduard Vieta4 and Zoltan Rihmer3 Abstract Background Anecdotal reports suggests that most clinicians treat medications as belonging to a class with regard to all therapeutic indications this means that the whole class of drugs is considered to possesses a specific therapeutic action. The present article explores the possible existence of a true class effect for agents available for the treatment of bipolar disorder. Methods We reviewed the available treatment data from randomized controlled trials RCTs and explored 16 agent class treatment issue cases for bipolar disorder. Four classes of agents were examined first-generation antipsychotics FGAs second-generation antipsychotics SGAs antiepileptics and antidepressants with respect to their efficacy on four treatment issues of bipolar disorder BD acute mania acute bipolar depression maintenance against mania maintenance against depression . Results From the 16 agent class treatment issue cases only 3 possible class effects were detected and they all concerned acute mania and antipsychotics. Four effect cases have not been adequately studied FGAs against acute bipolar depression and in maintenance protection from depression and antidepressants against acute mania and protection from mania and they all concern treatment cases with a high risk of switching to the opposite pole thus research in these areas is poor. There is no class effect at all concerning antiepileptics. Conclusions The available data suggest that a class effect is the exception rather than the rule in the treatment of BD. However the possible presence of a class effect concept discourages clinicians from continued scientific training and reading. Focused educational intervention .