title: THE AMERICAN SOCIETY OF CLINICAL PSYCHOPHARMACOLOGY SURVEY OF PSYCHOPHARMACOLOGISTS' PRACTICE PATTERNS FOR THE TREATMENT OF MOOD DISORDERS.
abstract: BACKGROUND
  Optimal successive treatment decisions are not well established after an initial medication nonresponse in major depressive disorder or bipolar disorder. While practice guidelines offer consensus-based expert treatment recommendations, little is known about "real world" pharmacology decision making by practicing psychopharmacologists.
  
  
  METHODS
  We surveyed via Internet the national membership of the American Society of Clinical Psychopharmacology (ASCP) to study preferred pharmacotherapy strategies and factors that influence medication choices for patients with mood disorders.
  
  
  RESULTS
  Surveys were returned by 154/752 ASCP members (21%). After nonresponse to a serotonin reuptake inhibitor in major depressive disorder, participants equally favored switching within or across antidepressant classes. After a partial response, adjunctive bupropion was the preferred intervention, followed by changing antidepressant classes. Atypical antipsychotic augmentation was only a fourth-line consideration, even though moderate or marked efficacy was perceived in most instances with olanzapine, aripiprazole, and quetiapine. Respondents favored avoiding antidepressants in bipolar I patients with mixed/cycling features or prior antidepressant-associated mania/hypomania. In rapid cyclers, they advocated antidepressant cessation and preferred the use of atypical antipsychotics and lamotrigine.
  
  
  CONCLUSIONS
  Participating psychopharmacologists treating adults with mood disorders report prescribing medications that largely mirror the evidence base with only a few notable exceptions, in consideration of the characteristics of definable clinical subpopulations.
authors.affiliation: Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Goldberg
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
authors.forename: Marlene P
authors.initials: MP
authors.lastname: Freeman
authors.affiliation: Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan.|Department of Anesthesiology, Wayne State University, Detroit, Michigan.
authors.forename: Richard
authors.initials: R
authors.lastname: Balon
authors.affiliation: Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York.
authors.forename: Leslie
authors.initials: L
authors.lastname: Citrome
authors.affiliation: Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.|Department of Psychiatry, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.affiliation: Department of Psychiatry, Zucker Hillside Hospital-North Shore Long Island Jewish Health System, Glen Oaks, New York.|Department of Psychiatry, Hofstra North Shore-Long Island Jewish School of Medicine, Uniondale, New York.|Behavior Health Services, North Shore-Long Island Jewish Health System, New Hyde Park, New York.
authors.forename: John M
authors.initials: JM
authors.lastname: Kane
authors.affiliation: Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts.|Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
mesh_terms: D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000188:drug therapy*; D010818:Practice Patterns, Physicians'; D011600:Psychopharmacology / Q000379:methods*; D012955:Societies, Medical; D014481:United States
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: antidepressant; antipsychotic; depression; mood stabilizer; psychopharmacology; survey