Systematic Reviews Now Available

Treatment for Bipolar Disorder in Adults: A Systematic Review
(Systematic Review, released on August 7, 2018)

Selected Key Messages:

Acute mania treatment: Lithium, asenapine, cariprazine, olanzapine, quetiapine, risperidone, and ziprasidone may modestly improve acute mania symptoms in adults with Bipolar Disorder type 1 (BD-I). Participants on atypical antipsychotics, except for quetiapine, reported more extrapyramidal symptoms, and those on olanzapine reported more weight gain, compared with placebo.
Maintenance treatment: Lithium may prevent relapse into acute episodes in adults with BD-I.
Depression treatment: Evidence was insufficient for drug treatments for depressive episodes in adults with BD-I and Bipolar Disorder type II (BD-II).
For adults with any BD type, cognitive behavioral therapy may be no better than other psychotherapies for improving acute bipolar symptoms and systematic/collaborative care may be no better than other behavioral therapies for preventing relapse of any acute symptoms.
Stronger conclusions were prevented by high rates of participants dropping out.

For more see: https://effectivehealthcare.ahrq.gov/topics/bipolar-disorder-treatment/final-report-2018

Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update
(Systematic Review, released on August 8, 2018) A systematic review funded by the Patient-Centered Outcomes Research Institute.

Selected Key Messages:

The nonpharmacological and pharmacological interventions studied, except hormones and periurethral bulking agents, result in better urinary incontinence (UI) outcomes than no treatment.
For stress UI, among treatments commonly used as first- or second-line interventions, behavioral therapy is more effective than either alpha agonists or hormones. Combination behavioral therapy and hormones are more effective than alpha agonists. Alpha agonists, in turn, are more effective than hormones.
There is insufficient evidence comparing periurethral bulking agents and intravesical pressure release, treatments used as third-line interventions for women with stress UI.
For urgency UI, among treatments commonly used as first- or second-line interventions, behavioral therapy is more effective than anticholinergics.
Onabotulinum toxin A may be more effective than neuromodulation as third-line therapy for women with urgency UI.
Dry mouth is the most common side effect of pharmacological interventions, particularly with anticholinergics. Duloxetine is associated with numerous constitutional adverse effects such as nausea, insomnia, and fatigue.
Serious adverse events are rare for all interventions. Onabotulinum toxin A is associated with risk of urinary tract infections and urinary retention. Periurethral bulking agents are associated with erosion in a small percentage of women.

For more see: https://effectivehealthcare.ahrq.gov/topics/urinary-incontinence-update/final-report-2018

About us: AHRQ’s Effective Health Care Program is committed to providing the best available evidence on the outcomes, benefits and harms, and appropriateness of drugs, devices, and health care services and by helping health care professionals, patients, policymakers, and health care systems make informed health care decisions. The program partners with research centers, academic institutions, health professional societies, consumer organizations, and other stakeholders to conduct research, evidence synthesis, evidence translation, dissemination, and implementation of research findings.

To learn more: https://www.effectivehealthcare.ahrq.gov

EHC Program Update: Bipolar Disorder and Urinary Incontinence in Women Final Reports