Evidence-Based Pharmacologic Treatment for People With Severe Mental Illness:A Focus on Guidelines and Algorithms

Abstract

Medication treatment of severe mental illness has been advanced and complicated by the introduction of numerous therapeutic agents. Practice guidelines based on research evidence have been developed to help clinicians make complex decisions. Studies of usual care sug- gest an important potential role for guidelines in improving the qual- ity of medication treatment for people with severe mental illness. The authors review current evidence-based guidelines for medication treatment of persons with severe mental illness. Four categories of guidelines are described: recommendations, comprehensive treat- ment options, medication algorithms, and expert consensus. The au- thors note that more research is needed on optimal next-step strate- gies and the treatment of patients with comorbidity and other compli- cating problems. They discuss barriers to the implementation of guidelines, and they observe that the potential of guidelines and algo- rithms to promote evidence-based medication treatment for persons with severe mental illness depends on refinement of tools, progress in research, and cooperation of physicians, nonphysician clinicians, ad- ministrators, and consumers and family members. (Psychiatric Ser- vices 52:619-625, 2001)