Abstract
Multiple treatments are available for nearly all the mood disorders. This range of
treatment options adds a new dimension of choice to clinical decision making. In addition
to prescribing the best initial treatment, clinicians should have an algorithm for
deciding if and when to make subsequent changes in treatment to take advantage of
second-line treatment options when necessary. This article aims to 1) show that a
wide variety of clinical decisions can be framed as choices among adaptive (within-patient)
threshold-based strategies or algorithms, illustrating the generality of the concept;
2) illustrate two ways to design randomized clinical trials to compare treatment strategies
with each other to decide which strategy is best; and 3) discuss some of the advantages
offered by these designs, in terms of both patient acceptability and adherence to
experimental protocols.
Keywords
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Article info
Publication history
Accepted:
June 2,
2000
Received in revised form:
June 1,
2000
Received:
March 22,
2000
Identification
Copyright
© 2000 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
