Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies
Authors: Yatham, Lakshmi N1; Kennedy, Sidney H2; O'Donovan, Claire3; Parikh, Sagar2; MacQueen, Glenda4; McIntyre, Roger2; Sharma, Verinder5; Silverstone, Peter6; Alda, Martin3; Baruch, Philippe7; Beaulieu, Serge8; Daigneault, Andree9; Milev, Roumen10; Young, L. Trevor2; Ravindran, Arun2; Schaffer, Ayal2; Connolly, Mary11; Gorman, Chris P12
Source: Bipolar Disorders, Volume 7, Supplement 3, June 2005 , pp. 5-69(65)
Publisher: Blackwell Publishing
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Abstract:
Yatham LN, Kennedy SH, O'Donovan C, Parikh S, MacQueen G, McIntyre R, Sharma V, Silverstone P, Alda M, Baruch P, Beaulieu S, Daigneault A, Milev R, Young T, Ravindran A, Schaffer A, Connolly M, Gorman CP. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies. Bipolar Disord 2005: 7 (Suppl. 3): 5–69. © Blackwell Munksgaard, 2005 Since the previous publication of Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines in 1997, there has been a substantial increase in evidence-based treatment options for bipolar disorder. The present guidelines review the new evidence and use criteria to rate strength of evidence and incorporate effectiveness, safety, and tolerability data to determine global clinical recommendations for treatment of various phases of bipolar disorder. The guidelines suggest that although pharmacotherapy forms the cornerstone of management, utilization of adjunctive psychosocial treatments and incorporation of chronic disease management model involving a healthcare team are required in providing optimal management for patients with bipolar disorder. Lithium, valproate and several atypical antipsychotics are first-line treatments for acute mania. Bipolar depression and mixed states are frequently associated with suicidal acts; therefore assessment for suicide should always be an integral part of managing any bipolar patient. Lithium, lamotrigine or various combinations of antidepressant and mood-stabilizing agents are first-line treatments for bipolar depression. First-line options in the maintenance treatment of bipolar disorder are lithium, lamotrigine, valproate and olanzapine. Historical and symptom profiles help with treatment selection. With the growing recognition of bipolar II disorders, it is anticipated that a larger body of evidence will become available to guide treatment of this common and disabling condition. These guidelines also discuss issues related to bipolar disorder in women and those with comorbidity and include a section on safety and monitoring.Document Type: Research article
DOI: 10.1111/j.1399-5618.2005.00219.x
Affiliations: 1: Department of Psychiatry, University of British Columbia, Vancouver, BC 2: Department of Psychiatry, University of Toronto, Toronto, ON 3: Department of Psychiatry, Dalhousie University, Halifax, NS 4: McMaster University, Hamilton, ON 5: Department of Psychiatry, University of Western Ontario, ON 6: Departments of Psychiatry and Neuroscience, Alberta, Edmonton, AB 7: gDepartment of Psychiatry, Laval University, Quebec City, QC 8: hDepartment of Psychiatry, McGill University, Montreal 9: iDepartment of Psychiatry, University of Montreal 10: jDepartment of Psychiatry, Queen's University, Kingston, ON 11: kMood Disorders Service, Victoria, BC 12: lUniversity of Calgary, Calgary, AB, Canada
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