Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations
Yatham, Lakshmi N.; Chakrabarty, Trisha; Bond, David J.; Schaffer, Ayal; Beaulieu, Serge; Parikh, Sagar V.; McIntyre, Roger S.; Milev, Roumen V.; Alda, Martin; Vazquez, Gustavo; Ravindran, Arun V.; Frey, Benicio N.; Sharma, Verinder; Goldstein, Benjamin I.; Rej, Soham; O’Donovan, Claire; Tourjman, Valerie; Kozicky, Jan-Marie; Kauer-Sant’Anna, Marcia; Malhi, Gin; Suppes, Trisha; Vieta, Eduard; Kapczinski, Flavio; Kanba, Shigenobu; Lam, Raymond W.; Kennedy, Sidney H.; Calabrese, Joseph; Berk, Michael; Post, Robert
2021-12
Citation
Yatham, Lakshmi N.; Chakrabarty, Trisha; Bond, David J.; Schaffer, Ayal; Beaulieu, Serge; Parikh, Sagar V.; McIntyre, Roger S.; Milev, Roumen V.; Alda, Martin; Vazquez, Gustavo; Ravindran, Arun V.; Frey, Benicio N.; Sharma, Verinder; Goldstein, Benjamin I.; Rej, Soham; O’Donovan, Claire ; Tourjman, Valerie; Kozicky, Jan-Marie ; Kauer‐Sant’Anna, Marcia ; Malhi, Gin; Suppes, Trisha; Vieta, Eduard; Kapczinski, Flavio; Kanba, Shigenobu; Lam, Raymond W.; Kennedy, Sidney H.; Calabrese, Joseph; Berk, Michael; Post, Robert (2021). "Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations." Bipolar Disorders (8): 767-788.
Abstract
ObjectivesThe 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided- a critical gap which the current update aims to address.MethodOverview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high- quality data and reliance on expert opinion.ResultsNo agents met threshold for first- line treatment of DSM- 5Â manic or depressive episodes with mixed features. For mania + mixed features second- line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second- line options. For DSM- IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first- line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second- line. Research on maintenance treatments following a DSM- 5Â mixed presentation is extremely limited, with third- line recommendations based on expert opinion. For maintenance treatment following a DSM- IV mixed episode, quetiapine (monotherapy or combination) is first- line, and lithium and olanzapine identified as second- line options.ConclusionThe CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.Publisher
American Psychiatric Association Wiley Periodicals, Inc.
ISSN
1398-5647 1399-5618
Other DOIs
Types
Article
Metadata
Show full item recordCollections
Remediation of Harmful Language
The University of Michigan Library aims to describe library materials in a way that respects the people and communities who create, use, and are represented in our collections. Report harmful or offensive language in catalog records, finding aids, or elsewhere in our collections anonymously through our metadata feedback form. More information at Remediation of Harmful Language.
Accessibility
If you are unable to use this file in its current format, please select the Contact Us link and we can modify it to make it more accessible to you.