Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies
Identifieur interne : 001830 ( Istex/Corpus ); précédent : 001829; suivant : 001831Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies
Auteurs : Lakshmi N. Yatham ; Sidney H. Kennedy ; Claire O'Donovan ; Sagar Parikh ; Glenda Macqueen ; Roger Mcintyre ; Verinder Sharma ; Peter Silverstone ; Martin Alda ; Philippe Baruch ; Serge Beaulieu ; Andree Daigneault ; Roumen Milev ; L. Trevor Young ; Arun Ravindran ; Ayal Schaffer ; Mary Connolly ; Chris P. GormanSource :
- Bipolar Disorders [ 1398-5647 ] ; 2005-06.
Abstract
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.
Url:
DOI: 10.1111/j.1399-5618.2005.00219.x
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Yatham</name><affiliation><mods:affiliation>Department of Psychiatry, University of British Columbia, Vancouver, BC</mods:affiliation></affiliation></author><author><name sortKey="Kennedy, Sidney H" sort="Kennedy, Sidney H" uniqKey="Kennedy S" first="Sidney H" last="Kennedy">Sidney H. Kennedy</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="O Donovan, Claire" sort="O Donovan, Claire" uniqKey="O Donovan C" first="Claire" last="O'Donovan">Claire O'Donovan</name><affiliation><mods:affiliation>Department of Psychiatry, Dalhousie University, Halifax, NS</mods:affiliation></affiliation></author><author><name sortKey="Parikh, Sagar" sort="Parikh, Sagar" uniqKey="Parikh S" first="Sagar" last="Parikh">Sagar Parikh</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="Macqueen, Glenda" sort="Macqueen, Glenda" uniqKey="Macqueen G" first="Glenda" last="Macqueen">Glenda Macqueen</name><affiliation><mods:affiliation>McMaster University, Hamilton, ON</mods:affiliation></affiliation></author><author><name sortKey="Mcintyre, Roger" sort="Mcintyre, Roger" uniqKey="Mcintyre R" first="Roger" last="Mcintyre">Roger Mcintyre</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="Sharma, Verinder" sort="Sharma, Verinder" uniqKey="Sharma V" first="Verinder" last="Sharma">Verinder Sharma</name><affiliation><mods:affiliation>Department of Psychiatry, University of Western Ontario, ON</mods:affiliation></affiliation></author><author><name sortKey="Silverstone, Peter" sort="Silverstone, Peter" uniqKey="Silverstone P" first="Peter" last="Silverstone">Peter Silverstone</name><affiliation><mods:affiliation>Departments of Psychiatry and Neuroscience, Alberta, Edmonton, AB</mods:affiliation></affiliation></author><author><name sortKey="Alda, Martin" sort="Alda, Martin" uniqKey="Alda M" first="Martin" last="Alda">Martin Alda</name><affiliation><mods:affiliation>Department of Psychiatry, Dalhousie University, Halifax, NS</mods:affiliation></affiliation></author><author><name sortKey="Baruch, Philippe" sort="Baruch, Philippe" uniqKey="Baruch P" first="Philippe" last="Baruch">Philippe Baruch</name><affiliation><mods:affiliation>gDepartment of Psychiatry, Laval University, Quebec City, QC</mods:affiliation></affiliation></author><author><name sortKey="Beaulieu, Serge" sort="Beaulieu, Serge" uniqKey="Beaulieu S" first="Serge" last="Beaulieu">Serge Beaulieu</name><affiliation><mods:affiliation>hDepartment of Psychiatry, McGill University, Montreal</mods:affiliation></affiliation></author><author><name sortKey="Daigneault, Andree" sort="Daigneault, Andree" uniqKey="Daigneault A" first="Andree" last="Daigneault">Andree Daigneault</name><affiliation><mods:affiliation>iDepartment of Psychiatry, University of Montreal</mods:affiliation></affiliation></author><author><name sortKey="Milev, Roumen" sort="Milev, Roumen" uniqKey="Milev R" first="Roumen" last="Milev">Roumen Milev</name><affiliation><mods:affiliation>jDepartment of Psychiatry, Queen's University, Kingston, ON</mods:affiliation></affiliation></author><author><name sortKey="Young, L Trevor" sort="Young, L Trevor" uniqKey="Young L" first="L. Trevor" last="Young">L. Trevor Young</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="Ravindran, Arun" sort="Ravindran, Arun" uniqKey="Ravindran A" first="Arun" last="Ravindran">Arun Ravindran</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="Schaffer, Ayal" sort="Schaffer, Ayal" uniqKey="Schaffer A" first="Ayal" last="Schaffer">Ayal Schaffer</name><affiliation><mods:affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</mods:affiliation></affiliation></author><author><name sortKey="Connolly, Mary" sort="Connolly, Mary" uniqKey="Connolly M" first="Mary" last="Connolly">Mary Connolly</name><affiliation><mods:affiliation>kMood Disorders Service, Victoria, BC</mods:affiliation></affiliation></author><author><name sortKey="Gorman, Chris P" sort="Gorman, Chris P" uniqKey="Gorman C" first="Chris P" last="Gorman">Chris P. Gorman</name><affiliation><mods:affiliation>lUniversity of Calgary, Calgary, AB, Canada</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Bipolar Disorders</title><idno type="ISSN">1398-5647</idno><idno type="eISSN">1399-5618</idno><imprint><publisher>Blackwell Publishing</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-06">2005-06</date><biblScope unit="volume">7</biblScope><biblScope unit="supplement">s3</biblScope><biblScope unit="page" from="5">5</biblScope><biblScope unit="page" to="69">69</biblScope></imprint><idno type="ISSN">1398-5647</idno></series><idno type="istex">470468E67BFC1BCD4EBD2B0FBFED0AA76660D3E4</idno><idno type="DOI">10.1111/j.1399-5618.2005.00219.x</idno><idno type="ArticleID">BDI219</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1398-5647</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Lakshmi N Yatham</name><affiliations><json:string>Department of Psychiatry, University of British Columbia, Vancouver, BC</json:string></affiliations></json:item><json:item><name>Sidney H Kennedy</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Claire O'Donovan</name><affiliations><json:string>Department of Psychiatry, Dalhousie University, Halifax, NS</json:string></affiliations></json:item><json:item><name>Sagar Parikh</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Glenda MacQueen</name><affiliations><json:string>McMaster University, Hamilton, ON</json:string></affiliations></json:item><json:item><name>Roger McIntyre</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Verinder Sharma</name><affiliations><json:string>Department of Psychiatry, University of Western Ontario, ON</json:string></affiliations></json:item><json:item><name>Peter Silverstone</name><affiliations><json:string>Departments of Psychiatry and Neuroscience, Alberta, Edmonton, AB</json:string></affiliations></json:item><json:item><name>Martin Alda</name><affiliations><json:string>Department of Psychiatry, Dalhousie University, Halifax, NS</json:string></affiliations></json:item><json:item><name>Philippe Baruch</name><affiliations><json:string>gDepartment of Psychiatry, Laval University, Quebec City, QC</json:string></affiliations></json:item><json:item><name>Serge Beaulieu</name><affiliations><json:string>hDepartment of Psychiatry, McGill University, Montreal</json:string></affiliations></json:item><json:item><name>Andree Daigneault</name><affiliations><json:string>iDepartment of Psychiatry, University of Montreal</json:string></affiliations></json:item><json:item><name>Roumen Milev</name><affiliations><json:string>jDepartment of Psychiatry, Queen's University, Kingston, ON</json:string></affiliations></json:item><json:item><name>L. Trevor Young</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Arun Ravindran</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Ayal Schaffer</name><affiliations><json:string>Department of Psychiatry, University of Toronto, Toronto, ON</json:string></affiliations></json:item><json:item><name>Mary Connolly</name><affiliations><json:string>kMood Disorders Service, Victoria, BC</json:string></affiliations></json:item><json:item><name>Chris P Gorman</name><affiliations><json:string>lUniversity of Calgary, Calgary, AB, Canada</json:string></affiliations></json:item></author><articleId><json:string>BDI219</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>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. 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Trevor</forename><surname>Young</surname></persName><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation></author><author xml:id="author-15"><persName><forename type="first">Arun</forename><surname>Ravindran</surname></persName><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation></author><author xml:id="author-16"><persName><forename type="first">Ayal</forename><surname>Schaffer</surname></persName><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation></author><author xml:id="author-17"><persName><forename type="first">Mary</forename><surname>Connolly</surname></persName><affiliation>kMood Disorders Service, Victoria, BC</affiliation></author><author xml:id="author-18"><persName><forename type="first">Chris P</forename><surname>Gorman</surname></persName><affiliation>lUniversity of Calgary, Calgary, AB, Canada</affiliation></author></analytic><monogr><title level="j">Bipolar Disorders</title><idno type="pISSN">1398-5647</idno><idno type="eISSN">1399-5618</idno><idno type="DOI">10.1111/(ISSN)1399-5618</idno><imprint><publisher>Blackwell Publishing</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2005-06"></date><biblScope unit="volume">7</biblScope><biblScope unit="supplement">s3</biblScope><biblScope unit="page" from="5">5</biblScope><biblScope unit="page" to="69">69</biblScope></imprint></monogr><idno type="istex">470468E67BFC1BCD4EBD2B0FBFED0AA76660D3E4</idno><idno type="DOI">10.1111/j.1399-5618.2005.00219.x</idno><idno type="ArticleID">BDI219</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2005</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>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. 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type="electronic">1399-5618</issn><idGroup><id type="product" value="BDI"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="BIPOLAR DISORDERS">Bipolar Disorders</title></titleGroup></publicationMeta><publicationMeta level="part" position="06000"><doi origin="wiley">10.1111/bdi.2005.7.issue-s3</doi><numberingGroup><numbering type="journalVolume" number="7">7</numbering><numbering type="supplement">s3</numbering></numberingGroup><coverDate startDate="2005-06">June 2005</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="1" status="forIssue"><doi origin="wiley">10.1111/j.1399-5618.2005.00219.x</doi><idGroup><id type="unit" value="BDI219"></id></idGroup><countGroup><count type="pageTotal" number="65"></count></countGroup><titleGroup><title type="tocHeading1">Canadian Network for Mood and Anxiety Treatments (CANMAT) Guidelines for the Management of Patients with Bipolar Disorder: Consensus, Controversies and International Commentaries</title></titleGroup><eventGroup><event type="firstOnline" date="2005-06-06"></event><event type="publishedOnlineFinalForm" date="2005-06-06"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:FullText result:FullText" date="2010-04-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-25"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-15"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="5">5</numbering><numbering type="pageLast" number="69">69</numbering></numberingGroup><objectNameGroup><objectName elementName="appendix">Appendix</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:BDI.BDI219.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="34"></count></countGroup><titleGroup><title type="main">Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies</title><title type="shortAuthors"><b>Yatham et al.</b></title><title type="short"><b>CANMAT guidelines for bipolar disorder</b></title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Lakshmi N</givenNames><familyName>Yatham</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>Sidney H</givenNames><familyName>Kennedy</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a3"><personName><givenNames>Claire</givenNames><familyName>O'Donovan</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>Sagar</givenNames><familyName>Parikh</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a4"><personName><givenNames>Glenda</givenNames><familyName>MacQueen</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a2"><personName><givenNames>Roger</givenNames><familyName>McIntyre</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a5"><personName><givenNames>Verinder</givenNames><familyName>Sharma</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a6"><personName><givenNames>Peter</givenNames><familyName>Silverstone</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a3"><personName><givenNames>Martin</givenNames><familyName>Alda</familyName></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a7"><personName><givenNames>Philippe</givenNames><familyName>Baruch</familyName></personName></creator><creator creatorRole="author" xml:id="cr11" affiliationRef="#a8"><personName><givenNames>Serge</givenNames><familyName>Beaulieu</familyName></personName></creator><creator creatorRole="author" xml:id="cr12" affiliationRef="#a9"><personName><givenNames>Andree</givenNames><familyName>Daigneault</familyName></personName></creator><creator creatorRole="author" xml:id="cr13" affiliationRef="#a10"><personName><givenNames>Roumen</givenNames><familyName>Milev</familyName></personName></creator><creator creatorRole="author" xml:id="cr14" affiliationRef="#a2"><personName><givenNames>L. Trevor</givenNames><familyName>Young</familyName></personName></creator><creator creatorRole="author" xml:id="cr15" affiliationRef="#a2"><personName><givenNames>Arun</givenNames><familyName>Ravindran</familyName></personName></creator><creator creatorRole="author" xml:id="cr16" affiliationRef="#a2"><personName><givenNames>Ayal</givenNames><familyName>Schaffer</familyName></personName></creator><creator creatorRole="author" xml:id="cr17" affiliationRef="#a11"><personName><givenNames>Mary</givenNames><familyName>Connolly</familyName></personName></creator><creator creatorRole="author" xml:id="cr18" affiliationRef="#a12"><personName><givenNames>Chris P</givenNames><familyName>Gorman</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Department of Psychiatry, University of British Columbia, Vancouver, BC</unparsedAffiliation></affiliation><affiliation xml:id="a2"><unparsedAffiliation>Department of Psychiatry, University of Toronto, Toronto, ON</unparsedAffiliation></affiliation><affiliation xml:id="a3"><unparsedAffiliation>Department of Psychiatry, Dalhousie University, Halifax, NS</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>McMaster University, Hamilton, ON</unparsedAffiliation></affiliation><affiliation xml:id="a5"><unparsedAffiliation>Department of Psychiatry, University of Western Ontario, ON</unparsedAffiliation></affiliation><affiliation xml:id="a6"><unparsedAffiliation>Departments of Psychiatry and Neuroscience, Alberta, Edmonton, AB</unparsedAffiliation></affiliation><affiliation xml:id="a7"><unparsedAffiliation><sup>g</sup>Department of Psychiatry, Laval University, Quebec City, QC</unparsedAffiliation></affiliation><affiliation xml:id="a8"><unparsedAffiliation><sup>h</sup>Department of Psychiatry, McGill University, Montreal</unparsedAffiliation></affiliation><affiliation xml:id="a9"><unparsedAffiliation><sup>i</sup>Department of Psychiatry, University of Montreal</unparsedAffiliation></affiliation><affiliation xml:id="a10"><unparsedAffiliation><sup>j</sup>Department of Psychiatry, Queen's University, Kingston, ON</unparsedAffiliation></affiliation><affiliation xml:id="a11"><unparsedAffiliation><sup>k</sup>Mood Disorders Service, Victoria, BC</unparsedAffiliation></affiliation><affiliation xml:id="a12" countryCode="CA"><unparsedAffiliation><sup>l</sup>University of Calgary, Calgary, AB, Canada</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><!-- 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 --><p>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.</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1" numbered="no"><p>This project was supported by unrestricted educational grants from Lilly, AstraZeneca and Janssen‐Ortho.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>CANMAT guidelines for bipolar disorder</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies</title></titleInfo><name type="personal"><namePart type="given">Lakshmi N</namePart><namePart type="family">Yatham</namePart><affiliation>Department of Psychiatry, University of British Columbia, Vancouver, BC</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sidney H</namePart><namePart type="family">Kennedy</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claire</namePart><namePart type="family">O'Donovan</namePart><affiliation>Department of Psychiatry, Dalhousie University, Halifax, NS</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sagar</namePart><namePart type="family">Parikh</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Glenda</namePart><namePart type="family">MacQueen</namePart><affiliation>McMaster University, Hamilton, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roger</namePart><namePart type="family">McIntyre</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Verinder</namePart><namePart type="family">Sharma</namePart><affiliation>Department of Psychiatry, University of Western Ontario, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Peter</namePart><namePart type="family">Silverstone</namePart><affiliation>Departments of Psychiatry and Neuroscience, Alberta, Edmonton, AB</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Martin</namePart><namePart type="family">Alda</namePart><affiliation>Department of Psychiatry, Dalhousie University, Halifax, NS</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Philippe</namePart><namePart type="family">Baruch</namePart><affiliation>gDepartment of Psychiatry, Laval University, Quebec City, QC</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Serge</namePart><namePart type="family">Beaulieu</namePart><affiliation>hDepartment of Psychiatry, McGill University, Montreal</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andree</namePart><namePart type="family">Daigneault</namePart><affiliation>iDepartment of Psychiatry, University of Montreal</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Roumen</namePart><namePart type="family">Milev</namePart><affiliation>jDepartment of Psychiatry, Queen's University, Kingston, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">L. Trevor</namePart><namePart type="family">Young</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arun</namePart><namePart type="family">Ravindran</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ayal</namePart><namePart type="family">Schaffer</namePart><affiliation>Department of Psychiatry, University of Toronto, Toronto, ON</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Mary</namePart><namePart type="family">Connolly</namePart><affiliation>kMood Disorders Service, Victoria, BC</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Chris P</namePart><namePart type="family">Gorman</namePart><affiliation>lUniversity of Calgary, Calgary, AB, Canada</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2005-06</dateIssued><copyrightDate encoding="w3cdtf">2005</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">3</extent><extent unit="tables">34</extent></physicalDescription><abstract lang="en">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. 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