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[German S3 guidelines on bipolar disorders-first update 2019 : What is new in pharmacotherapy?]
Nervenarzt. 2020 Mar; 91(3):216-221.N

Abstract

BACKGROUND

German S3 guidelines are subject to the highest methodological standards. This includes that they are only valid for a certain time period. Following the first edition in 2012 the first update of the S3 guidelines on bipolar disorder has now been published (2019).

OBJECTIVE

What has changed in the field of pharmacological recommendations comparing the first edition with the update in 2019?

MATERIAL AND METHODS

Comparison of the 1st edition from 2012 with the update from 2019 of the S3 guidelines for the diagnostics and treatment of bipolar disorders.

RESULTS

The three principle treatment targets of acute treatment of bipolar depression, acute treatment of mania and phase prophylaxis (maintenance treatment) can be distinguished. For acute treatment of bipolar depression, for the first time a medication has received a level A recommendation: quetiapine. For the acute treatment of mania, several drugs are still recommended with the same level of recommendation (B). Asenapine has been added as the tenth substance. Lithium is still the only drug with a level A recommendation for maintenance and prophylactic treatment and is also the only drug approved for this indication without restrictions. A new recommendation is that in the absence of contraindications, phase prophylaxis with a serum level of at least 0.6 mmol/l should be carried out. With a B recommendation, quetiapine has been added to the drugs for phase prophylactic treatment.

CONCLUSION

The S3 guidelines make recommendations at the highest scientific level. In view of these findings, lithium is clearly underutilized for maintenance therapy. In the absence of clear contraindications (advanced renal insufficiency), every patient with bipolar disease should be given the chance of lithium prophylaxis for an adequately long period.

Authors+Show Affiliations

Abteilung für Psychiatrie, Schlosspark-Klinik, Heubnerweg 2, 14059, Berlin, Deutschland. bschor@schlosspark-klinik.de. Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland. bschor@schlosspark-klinik.de.Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität zu Köln, Köln, Deutschland.Psychiatrie Schwäbisch Hall, Schwäbisch Hall, Deutschland. Paracelsus Medizinische Privatuniversität Nürnberg, Nürnberg, Deutschland.Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.Vitos Philippshospital Riedstadt, Riedstadt, Deutschland.Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland.

Pub Type(s)

Journal Article
Review

Language

ger

PubMed ID

31932883

Citation

Bschor, T, et al. "[German S3 Guidelines On Bipolar Disorders-first Update 2019 : what Is New in Pharmacotherapy?]." Der Nervenarzt, vol. 91, no. 3, 2020, pp. 216-221.
Bschor T, Baethge C, Grunze H, et al. [German S3 guidelines on bipolar disorders-first update 2019 : What is new in pharmacotherapy?]. Nervenarzt. 2020;91(3):216-221.
Bschor, T., Baethge, C., Grunze, H., Lewitzka, U., Scherk, H., Severus, E., & Bauer, M. (2020). [German S3 guidelines on bipolar disorders-first update 2019 : What is new in pharmacotherapy?]. Der Nervenarzt, 91(3), 216-221. https://doi.org/10.1007/s00115-019-00852-5
Bschor T, et al. [German S3 Guidelines On Bipolar Disorders-first Update 2019 : what Is New in Pharmacotherapy?]. Nervenarzt. 2020;91(3):216-221. PubMed PMID: 31932883.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [German S3 guidelines on bipolar disorders-first update 2019 : What is new in pharmacotherapy?] AU - Bschor,T, AU - Baethge,C, AU - Grunze,H, AU - Lewitzka,U, AU - Scherk,H, AU - Severus,E, AU - Bauer,M, PY - 2020/1/15/pubmed PY - 2020/7/31/medline PY - 2020/1/15/entrez KW - Bipolar affective disorder KW - Bipolar depression KW - Lithium KW - Mania KW - Phase prophylaxis SP - 216 EP - 221 JF - Der Nervenarzt JO - Nervenarzt VL - 91 IS - 3 N2 - BACKGROUND: German S3 guidelines are subject to the highest methodological standards. This includes that they are only valid for a certain time period. Following the first edition in 2012 the first update of the S3 guidelines on bipolar disorder has now been published (2019). OBJECTIVE: What has changed in the field of pharmacological recommendations comparing the first edition with the update in 2019? MATERIAL AND METHODS: Comparison of the 1st edition from 2012 with the update from 2019 of the S3 guidelines for the diagnostics and treatment of bipolar disorders. RESULTS: The three principle treatment targets of acute treatment of bipolar depression, acute treatment of mania and phase prophylaxis (maintenance treatment) can be distinguished. For acute treatment of bipolar depression, for the first time a medication has received a level A recommendation: quetiapine. For the acute treatment of mania, several drugs are still recommended with the same level of recommendation (B). Asenapine has been added as the tenth substance. Lithium is still the only drug with a level A recommendation for maintenance and prophylactic treatment and is also the only drug approved for this indication without restrictions. A new recommendation is that in the absence of contraindications, phase prophylaxis with a serum level of at least 0.6 mmol/l should be carried out. With a B recommendation, quetiapine has been added to the drugs for phase prophylactic treatment. CONCLUSION: The S3 guidelines make recommendations at the highest scientific level. In view of these findings, lithium is clearly underutilized for maintenance therapy. In the absence of clear contraindications (advanced renal insufficiency), every patient with bipolar disease should be given the chance of lithium prophylaxis for an adequately long period. SN - 1433-0407 UR - https://www.unboundmedicine.com/medline/citation/31932883/[German_S3_guidelines_on_bipolar_disorders-first_update_2019_:_What_is_new_in_pharmacotherapy] L2 - https://dx.doi.org/10.1007/s00115-019-00852-5 DB - PRIME DP - Unbound Medicine ER -