Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies
Identifieur interne : 000903 ( Main/Exploration ); précédent : 000902; suivant : 000904Canadian 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 [Canada] ; Andree Daigneault [Canada] ; Roumen Milev ; L. Trevor Young ; Arun Ravindran ; Ayal Schaffer ; Mary Connolly ; Chris P. Gorman [Canada]Source :
- 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
Affiliations:
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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><affiliations><list><country><li>Canada</li></country><region><li>Alberta</li><li>Québec</li></region><settlement><li>Calgary</li><li>Montréal</li></settlement><orgName><li>Université de Calgary</li></orgName></list><tree><noCountry><name sortKey="Alda, Martin" sort="Alda, Martin" uniqKey="Alda M" first="Martin" last="Alda">Martin Alda</name><name sortKey="Baruch, Philippe" sort="Baruch, Philippe" uniqKey="Baruch P" first="Philippe" last="Baruch">Philippe Baruch</name><name sortKey="Connolly, Mary" sort="Connolly, Mary" uniqKey="Connolly M" first="Mary" last="Connolly">Mary Connolly</name><name sortKey="Kennedy, Sidney H" sort="Kennedy, Sidney H" uniqKey="Kennedy S" first="Sidney H" last="Kennedy">Sidney H. Kennedy</name><name sortKey="Macqueen, Glenda" sort="Macqueen, Glenda" uniqKey="Macqueen G" first="Glenda" last="Macqueen">Glenda Macqueen</name><name sortKey="Mcintyre, Roger" sort="Mcintyre, Roger" uniqKey="Mcintyre R" first="Roger" last="Mcintyre">Roger Mcintyre</name><name sortKey="Milev, Roumen" sort="Milev, Roumen" uniqKey="Milev R" first="Roumen" last="Milev">Roumen Milev</name><name sortKey="O Donovan, Claire" sort="O Donovan, Claire" uniqKey="O Donovan C" first="Claire" last="O'Donovan">Claire O'Donovan</name><name sortKey="Parikh, Sagar" sort="Parikh, Sagar" uniqKey="Parikh S" first="Sagar" last="Parikh">Sagar Parikh</name><name sortKey="Ravindran, Arun" sort="Ravindran, Arun" uniqKey="Ravindran A" first="Arun" last="Ravindran">Arun Ravindran</name><name sortKey="Schaffer, Ayal" sort="Schaffer, Ayal" uniqKey="Schaffer A" first="Ayal" last="Schaffer">Ayal Schaffer</name><name sortKey="Sharma, Verinder" sort="Sharma, Verinder" uniqKey="Sharma V" first="Verinder" last="Sharma">Verinder Sharma</name><name sortKey="Silverstone, Peter" sort="Silverstone, Peter" uniqKey="Silverstone P" first="Peter" last="Silverstone">Peter Silverstone</name><name sortKey="Yatham, Lakshmi N" sort="Yatham, Lakshmi N" uniqKey="Yatham L" first="Lakshmi N" last="Yatham">Lakshmi N. Yatham</name><name sortKey="Young, L Trevor" sort="Young, L Trevor" uniqKey="Young L" first="L. Trevor" last="Young">L. Trevor Young</name></noCountry><country name="Canada"><region name="Québec"><name sortKey="Beaulieu, Serge" sort="Beaulieu, Serge" uniqKey="Beaulieu S" first="Serge" last="Beaulieu">Serge Beaulieu</name></region><name sortKey="Daigneault, Andree" sort="Daigneault, Andree" uniqKey="Daigneault A" first="Andree" last="Daigneault">Andree Daigneault</name><name sortKey="Gorman, Chris P" sort="Gorman, Chris P" uniqKey="Gorman C" first="Chris P" last="Gorman">Chris P. Gorman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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