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

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  • GM Goodwin
    University Department of Psychiatry, Warneford Hospital, Oxford, UK
  • PM Haddad
    Greater Manchester West Mental Health NHS Foundation Trust, Eccles, Manchester, UK
  • IN Ferrier
    Institute of Neuroscience, Newcastle University, UK and Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
  • JK Aronson
    Centre for Evidence Based Medicine, Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Oxford, UK
  • TRH Barnes
    The Centre for Mental Health, Imperial College London, Du Cane Road, London, UK
  • A Cipriani
    University Department of Psychiatry, Warneford Hospital, Oxford, UK
  • DR Coghill
    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
  • S Fazel
    University Department of Psychiatry, Warneford Hospital, Oxford, UK
  • JR Geddes
    University Department of Psychiatry, Warneford Hospital, Oxford, UK
  • H Grunze
    Univ. Klinik f. Psychiatrie u. Psychotherapie, Christian Doppler Klinik, Universitätsklinik der Paracelsus Medizinischen Privatuniversität (PMU), Salzburg, Christian Doppler Klinik Salzburg, Austria
  • EA Holmes
    MRC Cognition & Brain Sciences Unit, Cambridge, UK
  • O Howes
    Institute of Psychiatry (Box 67), London, UK
  • S Hudson
    Bipolar UK, London, UK
  • N Hunt
    Fulbourn Hospital, Cambridge, UK
  • I Jones
    MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, UK
  • IC Macmillan
    Northumberland, Tyne and Wear NHS Foundation Trust, Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK
  • H McAllister-Williams
    Institute of Neuroscience, Newcastle University, UK and Northumberland Tyne and Wear NHS Foundation Trust, Newcastle, UK
  • DR Miklowitz
    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
  • R Morriss
    Division of Psychiatry and Applied Psychology, Institute of Mental Health, University of Nottingham Innovation Park, Nottingham, UK
  • M Munafò
    MRC Integrative Epidemiology Unit, UK Centre for Tobacco and Alcohol Studies, School of Experimental Psychology, University of Bristol, Bristol, UK
  • C Paton
    Oxleas NHS Foundation Trust, Dartford, UK
  • BJ Sahakian
    Department of Psychiatry (Box 189), University of Cambridge School of Clinical Medicine, Addenbrooke’s Hospital, Cambridge, UK
  • KEA Saunders
    University Department of Psychiatry, Warneford Hospital, Oxford, UK
  • JMA Sinclair
    University Department of Psychiatry, Southampton, UK
  • D Taylor
    South London and Maudsley NHS Foundation Trust, Pharmacy Department, Maudsley Hospital, London, UK
  • E Vieta
    Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
  • AH Young
    Centre for Affective Disorders, King’s College London, London, UK

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<jats:p> 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. </jats:p>

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