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Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care

Bipolar Disorder: The Management of Bipolar Disorder in Adults, Children and Adolescents, in Primary and Secondary Care

NICE Clinical Guidelines - National Collaborating Centre for Mental Health (UK)

Version: 2006

THE MEDICAL AND PHARMACOLOGICAL MANAGEMENT OF BIPOLAR DISORDER – PART I

Effective pharmacological treatment of bipolar disorder requires treatment of depressive and manic/hypomanic episodes together with long-term treatment to prevent future episodes, both syndromal and sub-syndromal. In recent years the importance of long-term treatment (that is, maintenance treatment) has been emphasised by several guidelines. The need for maintenance treatment is supported by the desire to prevent the costs of future episodes, that is, the intangible suffering to patients and their families and the economic burden of direct and indirect costs. In addition maintenance treatment may reduce long-term impairment associated with the bipolar disorder. There is evidence that functional impairment in patients who have recovered from acute episodes and are asymptomatic is related to the number of previous depressive episodes. The tendency for episodes to become more frequent with time also supports the rationale for maintenance treatment.

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