Decision model for the acute treatment of mania.
Decision making in psychiatric diagnosis and treatment has not been evaluated systematically. The authors present a model for treatment of an acute manic episode using a decision analysis software program. Six treatment options were put into the model: lithium, valproate, carbamezepine, electroconvulsive therapy, clonazepam, and neuroleptics. Each treatment was evaluated on three factors, efficacy, tolerability, and cost, using data from the literature and pharmacy and billing information. Output from the computer program identified three top choices among the six options: valproate, carbamazepine, and lithium, with valproate emerging as the first choice using the data we inputted.
Steffens
D C
DC
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Krishnan
K R
KR
D018692:Antimanic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D001185:Artificial Intelligence; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000191:economics / Q000523:psychology; D002220:Carbamazepine / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D002998:Clonazepam / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003658:Decision Making, Computer-Assisted; D003661:Decision Support Techniques; D004565:Electroconvulsive Therapy / Q000009:adverse effects / Q000191:economics; D005103:Expert Systems; D006801:Humans; D016651:Lithium Carbonate / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012984:Software; D016896:Treatment Outcome; D014635:Valproic Acid / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D018692:Antimanic Agents; D014150:Antipsychotic Agents; D016651:Lithium Carbonate; D002220:Carbamazepine; D002998:Clonazepam; D014635:Valproic Acid