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J Psychopharmacol. 2016 Jun;30(6):495-553. doi: 10.1177/0269881116636545. Epub 2016 Mar 15.

Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology.

Author information

1
University Department of Psychiatry, Warneford Hospital, Oxford, UK guy.goodwin@psych.ox.ac.uk.
2
Greater Manchester West Mental Health NHS Foundation Trust, Eccles, Manchester, UK.
3
Institute of Neuroscience, Newcastle University, UK and Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK.
4
Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK.
5
The Centre for Mental Health, Imperial College London, Du Cane Road, London, UK.
6
University Department of Psychiatry, Warneford Hospital, Oxford, UK.
7
MACHS 2, Ninewells' Hospital and Medical School, Dundee, UK; now Departments of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, VIC, Australia.
8
Univ. Klinik f. Psychiatrie u. Psychotherapie, Christian Doppler Klinik, Universitätsklinik der Paracelsus Medizinischen Privatuniversität (PMU), Salzburg, Christian Doppler Klinik Salzburg, Austria.
9
MRC Cognition & Brain Sciences Unit, Cambridge, UK.
10
Institute of Psychiatry (Box 67), London, UK.
11
Bipolar UK, London, UK.
12
Fulbourn Hospital, Cambridge, UK.
13
MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, UK.
14
Northumberland, Tyne and Wear NHS Foundation Trust, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK.
15
UCLA Semel Institute for Neuroscience and Human Behavior, Division of Child and Adolescent Psychiatry, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
16
Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK.
17
MRC Integrative Epidemiology Unit, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK.
18
Oxleas NHS Foundation Trust, Dartford, UK.
19
Department of Psychiatry (Box 189), University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge, UK.
20
University Department of Psychiatry, Southampton, UK.
21
South London and Maudsley NHS Foundation Trust, Pharmacy Department, Maudsley Hospital, London, UK.
22
Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain.
23
Centre for Affective Disorders, King's College London, London, UK.

Abstract

The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.

KEYWORDS:

Bipolar disorder; antidepressants; antipsychotics; cognitive behaviour therapy; evidence-based guidelines; lithium; mood stabilizers; psychoeducation; treatment

PMID:
26979387
PMCID:
PMC4922419
DOI:
10.1177/0269881116636545
[Indexed for MEDLINE]
Free PMC Article

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