Updates to Bipolar 1 Disorder, Depression, and Heart Failure – Chronic

All TreatGx users now have access to the updated treatment algorithms for Depression, Bipolar 1 Disorder, and Heart Failure – Chronic. As always, all updates include the TreatGx standard of providing personalized dosing based on pharmacogenetics, kidney function, liver function, contraindications, allergies/intolerances, and drug-drug interactions.

Depression

The order of drugs offered was shifted to more closely reflect CANMAT 2016 [1] and APA 2019 [2] Guidelines. Either monotherapy or augmentation/adjunctive therapy can be selected as a treatment strategy. Selegiline patches were added as a line 2 antidepressant option for the US, and modafinil was added to augmentation/adjunctive therapy options for CA. To provide more transparency, antidepressant side effect profiles and associated sorting functions have been updated based on a single international guideline source, WFSBP 2007 [3], and there continues to be 10 options for side effect profile sorting, to better customize patient medication options in addition to other factors accounted for.

Bipolar I Disorder

This update refreshes the dosing of every drug recommendation from CANMAT/ISBD 2018 guidelines[4]. Antipsychotic side effect profiles have also been revised to follow the international guideline source, WFSBP 2007[5]. Additional prescribing information and warning banners have been included, and indications for off-label drugs have also been made more transparent to better help guide your drug selection.

Heart Failure – Chronic

This Heart failure update includes recommendations from the 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure[6]. This includes recommendations for HFmrEF (heart failure with mildly reduced ejection fraction) and HFpEF (heart failure with preserved ejection fraction) as well as target dosing for HFrEF (heart failure with reduced ejection fraction). This update also includes the addition of the new drug Vericiguat.

References

1. Kennedy SH, Lam RW, McIntyre RS, Tourjman SV, Bhat V, Blier P, Hasnain M, Jollant F, Levitt AJ, MacQueen GM et al: Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder: Section 3. Pharmacological Treatments. Can J Psychiatry 2016, 61(9):540-560.
2. American Psychological Association: Clinical practice guideline for the treatment of depression across three age cohorts. 2019.
3. Bauer M, Bschor T, Pfennig A, Whybrow PC, Angst J, Versiani M, Moller HJ: World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders in Primary Care. World J Biol Psychiatry 2007, 8(2):67-104.
4. Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Bond DJ, Frey BN, Sharma V, Goldstein BI, Rej S, Beaulieu S et al: Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord 2018, 20(2):97-170.
5. Bauer M, Bschor T, Pfennig A, Whybrow PC, Angst J, Versiani M, Moller HJ: World Federation of Societies of Biological Psychiatry (WFSBP) Guidelines for Biological Treatment of Unipolar Depressive Disorders in Primary Care. The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry 2007, 8(2):67-104.
6. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR et al: 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. Journal of the American College of Cardiology 2022, 79(17):e263-e421.