Universität zu Köln

Bschor, T., Baethge, C., Grunze, H., Lewitzka, U., Scherk, H., Severus, E. and Bauer, M. (2020). German S3 guidelines on bipolar disorders-first update 2019 What is new in pharmacotherapy? Nervenarzt, 91 (3). S. 216 - 222. NEW YORK: SPRINGER. ISSN 1433-0407

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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 0.6x202f;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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bschor, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Baethge, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Grunze, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewitzka, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherk, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Severus, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-343054
DOI:	10.1007/s00115-019-00852-5
Journal or Publication Title:	Nervenarzt
Volume:	91
Number:	3
Page Range:	S. 216 - 222
Date:	2020
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1433-0407
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DOUBLE-BLIND; I DEPRESSION; CLINICAL GUIDELINES; ADJUNCTIVE THERAPY; PLACEBO; QUETIAPINE; MONOTHERAPY; LITHIUM; TRIAL; LURASIDONE Multiple languages Clinical Neurology; Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/34305