期刊
INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY
卷 20, 期 2, 页码 180-195出版社
OXFORD UNIV PRESS
DOI: 10.1093/ijnp/pyw109
关键词
bipolar disorder; anticonvulsants; antidepressants; antipsychotics; evidence; based guidelines; lithium; mania; bipolar depression; mood stabilizers; treatment; clinical trials
资金
- AstraZeneca
- Bristol-Myers Squibb
- Eli Lilly
- Ferrer
- Gedeon Richter
- Janssen
- Lundbeck
- Otsuka
- Pfizer
- Pfizer Foundation
- Sanofi-Aventis
- Servier
- Shire
- Allergan
- Dainippon Sumitomo Pharma
- Forest Research Institute
- GlaxoSmithKline
- Lilly
- Roche
- Sunovion
- Takeda
- Brain and Behaviour Foundation
- Spanish Ministry of Science and Innovation (CIBERSAM)
- Seventh European Framework Programme (ENBREC)
- Stanley Medical Research Institute
- NIHR-BRC (UK)
- NIMH (USA)
- CIHR (Canada)
- NARSAD (USA)
- Stanley Medical Research Institute (USA)
- MRC (UK)
- Wellcome Trust (UK)
- Royal College of Physicians (Edin)
- BMA (UK)
- UBC-VGH Foundation (Canada)
- WEDC (Canada)
- CCS Depression Research Fund (Canada)
- MSFHR (Canada)
- NIHR (UK)
- NIHR UK
- MRC UK
- NTW NHS Foundation Trust
- Gedeon-Richter
- Hofmann-LaRoche
- BMS
- Janssen-Cilag
- Alkermes
- Bristol Myers Squibb
- CANMAT
- CIHR
- Forest
- Intas
- Michael Smith Foundation for Health Research
- Sumitomo Dainippon
- Stanley Foundation
- Angelini
- AOP Orphan Pharmaceuticals AG
- KRKA-Pharma
- Neuraxpharm
- Pierre Fabre
- Schwabe
- Bayer
- Canadian Institute for Health Research
- Ontario Brain Institute
- Meda-Valeant
- Merck
- Pierre Fabre Medicaments
Background: The current paper introduces the actual International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder. Concept and structure of the guidelines: The current clinical guidelines are based on evidence-based data, but they also intend to be clinically useful, while a rigid algorithm was developed on the basis of firm evidence alone. Monotherapy was prioritized over combination therapy. There are separate recommendations for each of the major phases of bipolar disorder expressed as a 5-step algorithm. Discussion: The current International College of Neuro-Psychopharmacology clinical guidelines for the treatment of bipolar disorder are the most up-to-date guidance and are as evidence based as possible. They also include recommendations concerning the use of psychotherapeutic interventions, again on the basis of available evidence. This adherence of the workgroup to the evidence in a clinically oriented way helped to clarify the role of specific antidepressants and traditional agents like lithium, valproate, or carbamazepine. The additional focus on specific clinical characteristics, including predominant polarity, mixed features, and rapid cycling, is also a novel approach. Many issues need further studies, data are sparse and insufficient, and many questions remain unanswered. The most important and still unmet need is to merge all the guidelines that concern different phases of the illness into a single one and in this way consider BD as a single unified disorder, which is the real world fact. However, to date the research data do not permit such a unified approach.
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