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Magellan updates five clinical practice guidelines

Revisions for ADHD, ASD, GAD, OCD, and managing the suicidal patient available online

Magellan’s clinical taskforce recently approved updates to five of the organization’s clinical practice guidelines. These guidelines serve as the evidence-based framework for practitioners’ clinical decision-making for the treatment of patients.

Highlights of the 2018 changes:

Attention-deficit/hyperactivity disorder (ADHD)

  • Adult late onset ADHD association with stimulant-seeking behavior
  • Evidence of efficacy of extended-release methylphenidate and amphetamine class stimulant medications and atomoxetine
  • Risks of ADHD medication for pregnant women
  • Impact of physical exercise on inattention, hyperactivity/impulsivity, anxiety, and cognitive functions in children and adolescents

Autism spectrum disorders (ASD)

  • Updates from the American Academy of Child and Adolescent Psychiatry Practice Parameter and information from the Agency for Healthcare Research and Quality
  • Psychiatric and medical comorbidities, specifically ADHD, anxiety and various depressive disorders, GI, sleep disorders
  • Routine evaluation of children for psychiatric and medical co-morbidities
  • “Theory of the Mind” intervention

Assessment and treatment of generalized anxiety disorder (GAD) in adults

  • Data that demonstrates GADs as second most common anxiety disorders in older adults following phobias
  • Investigation of biometrics through neuroimaging and genetics, and the significant overlap between GAD and depression
  • Efficacy of CBT with older adults with GAD; ability of individuals with GAD to predict consequences and incorporate that learning and feedback

Obsessive-compulsive disorder (OCD)

  • High rates of co-morbidity with major depression, phobias, GAD and obsessive-compulsive personality disorder
  • Trajectory of improvement with SSRIs
  • Deep brain treatment study that found promising results after initial treatment and at one year follow up, albeit with small sample size
  • SSRI treatment augmented with an antipsychotic medication; comparison with TMS

Managing the suicidal patient

  • Studies: WHO (2014) and National Action Alliance for Suicide Prevention (2018) as standard care for patients at risk for suicide; June 2018 CDC report on Trends in State Suicide Rates (Stone, DM, et al., 2018)
  • Increased suicide rates for adolescents and young adults
  • Risk factors, including bullying, LGBTQ, family history, access to firearms, military service, and sleep disturbance; mental health treatment history and gaps in care
  • Assessment and lethality screening in primary care, emergency departments
  • Applied Suicide Intervention Skills Training (ASIST), safeTalk and suicideTalk

Magellan’s adopted guidelines are intended to augment, not replace, sound clinical judgment. We welcome your feedback and will consider all suggestions and recommendations in our next review. You may submit comments to your regional Magellan provider advisory group, medical director or to

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Welcome to Provider Focus, our award-winning e-newsletter for network providers! Here you’ll find articles and information to keep you up-to-date on news and topics relevant to serving Magellan members, including a section for regional- and plan-specific news. Check back as a new issue is released each quarter.

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