Best practices: comparing medication treatments in mental health: drug class reviews and policy challenges

Advances in the number and type of medications for psychiatric illness have substantially aided physicians. However, as the number of available medications within a class increases, so does the complexity in decision making for provider and patient. Systematic review of a class of medications can assist providers in drug choice. The purpose and methods of such drug class reviews are described. Critical elements of a quality review include the choice of the question, explicit eligibility criteria, systematic search of the literature, article abstraction, and sometimes pooling of the data by using meta-analysis with direct or indirect comparison of study findings. Best practices are suggested for clinicians, administrators, and policy makers to consider when using drug class reviews in clinical organizations. The number of drug class reviews is increasing, and they have the potential to significantly assist providers, patients, and payers.