Special review articleTreatment guidelines for bipolar disorder: A critical review
Introduction
The development of treatment guidelines emerged as an important element so as to standardize treatment and to provide clinicians with algorithms, which would be able to carry research findings to the everyday clinical practice, by organizing information from diverse sources into an easily accessible format.
The aim of the current study is to review contemporary available treatment guidelines for bipolar disorder. Although several issues are relevant (adolescence, old age, pregnancy, comorbid conditions) this article focuses on the treatment guidelines concerning otherwise physically healthy and physiologically stable adults suffering from bipolar disorders.
Section snippets
Material and method
The MEDLINE was searched with the combination of each one of the key words ‘mania’, ‘manic’, ‘bipolar’, ‘manic-depression’, ‘manic-depressive’ with ‘treatment guidelines’ and ‘treatment algorithms’. The search returned 224 articles. The search was updated until March 1st, 2004. Finally the review process based on the titles and abstracts selected 84 of them for further study. Among them there were 23 papers concerning structured treatment algorithms proposed by official panels (1997, AACAP, 1997
Results
American Psychiatric Association treatment guidelines: The first detailed operational treatment guidelines concerning bipolar disorder published, were those of the American Psychiatric Association (American Psychiatric Association, 1994, American Psychiatric Association, 1995, American Psychiatric Association, 2002). Their development was based on expert opinion and reviewers which evaluated all available evidence. The first version was published in 1994. In that version, five types of
Discussion
Bipolar illness has a complex clinical picture and an even more complex treatment. There are more than one traditional clinical approach to treatment with a traditional difference between academic authorities in Europe (in favor of the use of antipsychotics and antidepressants) and the US (in favor of so-called mood stabilizers).
The various treatment guidelines generally seem to have a common starting point, best described by the 1994 APA guidelines (American Psychiatric Association, 1994). But
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