Dispelling the Myths: Point-Counterpoint Debate on European and US Treatment Guidelines for Bipolar Disorder
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Session Summary
Bipolar disorder affects approximately 1% of the worldwide population. Several pharmacologic options are available to treat this condition and treatment guidelines are available to direct treatment. Common treatment guidelines in the United States include the American Psychiatric Association guidelines, the Expert Consensus Guidelines, and the Texas Implementation of Medical Algorithms for Bipolar Disorder treatment algorithm, while European guidelines include the European Collegeof Neuropsychopharmacology (ECNP) Consensus Statement on Bipolar Disorder and the National Institute for Health and Clinical Excellence (NICE) guidelines.
Although similarities exist between the U.S. And European guidelines, several key differences are also apparent. or example, carbamazepine is considered a second-line option for the treatment of mania or hypomania in the US, while the NICE guidelines advise against the routine use of carbamazepine in Europe. In the US, lamotrigine is recommended as a potential first-line option for treatment of acute bipolar depression, while the NICE guidelines state that lamotrigine should not be used as a single, first-line agent. Finally, the US guidelines support that use of risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole as potential first or second-line options for the treatment of manic/hypomanic episodes while the NICE guidelines only routinely recommend the use of risperidone, olanzapine, and quetiapine. In this session, evidence supporting each country's recommendations will be presented and debated in a point-counterpoint format.
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Faculty Information
Charles L. Bowden, MD
Heinz C.R. Grunze, MD,PHD
Learning Objectives
- Describe and compare current European and US guidelines for the treatment of bipolar disorder, noting key differences.
- Examine the literature on the efficacy of lamotrigine for the acute and maintenance treatment of bipolar disorder.
- Review the role of antidepressants in the treatment of bipolar depression.
- Differentiate the effectiveness of the available second-generation antipsychotics in the treatment of bipolar disorder.
- Analyze the current data available regarding the efficacy of carbamazepine for the acute and maintenance treatment of bipolar disorder.
Continuing Education Credit
Activity Dates: 04/21/2009 - 04/21/2012
ACPE Contact Hours: 2.0
ACPE Number: 0284-0000-09-009-H01-P
Nursing Credit Reminder: Note that ACPE and ACCME credit is accepted for certification renewal.
The College of Psychiatric and Neurologic Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. This self-study course provides 2.0 contact hours (0.2 CEUs) of knowledge-based continuing education credit from CPNP approved programming. The ACPE universal program number assigned to this course is 0284-0000-09-009-H01-P (2.0 contact hours).
ACPE approved contact hours are accepted for ANCC Certification Renewal (see pages 5 and 6): At least 50% (37.5 hours) of your 75 continuing education hours must be formally approved continuing education hours. Formally approved continuing education hours meet one or more of the criteria listed below:
- Continuing nursing education (CNE) approved for nursing contact hours by an accredited provider or approver of nursing continuing education
- Continuing medical education (CME) approved for CME hours
- Sponsored by organizations, agencies, or educational institutions accredited or approved by the American Nurses Credentialing Center (ANCC) or the Accreditation Council for Continuing Medical Education (ACCME) or the Accreditation Council for Pharmacy Education (ACPE) or the Commission on Dietetic Registration
Course Requirements
This course is provided online at cpnp.org and consists of the speaker audio and slides. A PDF file of the slides is also provided and access is available to participants indefinitely although ACPE credit is available only through the course expiration date.
Participants in this course must complete an examination and achieve a score of 60% or greater. Successful completion of the course also requires the completion of a course evaluation. ACPE statements of credit can be retrieved by participants online at cpnp.org immediately upon successful completion of the course.
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- Adobe Flash Player 8+
- 512MB RAM
- Any Operating System capable of the above requirements
- Internet Explorer 7+, Firefox 3+ or Safari 3+
- 1280x768 resolution or greater
- Adobe Flash Player 10+
- Windows XP/2000/Vista and Mac OS 10.4 or better
- 512MB of RAM for Windows XP or Mac OS
- 1GB of RAM for Windows Vista
Minimum:
Recommended:
Target Audience
If you are a pharmacist, nurse practitioner or other healthcare professional involved in the medication therapy management of psychiatric and/or neurological patients, we invite you to participate in this online course.
Grant Support
This programming was supported in part by grants from Bristol-Myers Squibb, Forest Laboratories, Inc., Lilly, Schering-Plough, Cyberonics, and Shire.