The authors dedicate the CANMAT/ISBD guidelines to Dr. Vivek Kusumakar, who passed away suddenly on January 14, 2009. He was an editor for the first CANMAT Guidelines for bipolar disorder, published in 1997. Dr. Kusumakar’s intellectual curiosity to understand the causes of mental illnesses, scientific ability to lead discovery and development of new treatments, develop and disseminate innovative educational programs to improve outcomes for people with bipolar disorder, and his drive for excellence, along with an ability to inject his vision and enthusiasm to his colleagues will be sorely missed.
Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009
Article first published online: 14 APR 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard
Volume 11, Issue 3, pages 225–255, May 2009
How to Cite
Yatham, L. N., Kennedy, S. H., Schaffer, A., Parikh, S. V., Beaulieu, S., O'Donovan, C., MacQueen, G., McIntyre, R. S., Sharma, V., Ravindran, A., Young, L. T., Young, A. H., Alda, M., Milev, R., Vieta, E., Calabrese, J. R., Berk, M., Ha, K. and Kapczinski, F. (2009), Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2009. Bipolar Disorders, 11: 225–255. doi: 10.1111/j.1399-5618.2009.00672.x
Affiliations and disclosure information for all authors are listed before the references.
- Issue published online: 14 APR 2009
- Article first published online: 14 APR 2009
- Received 17 October 2008, revised and accepted for publication 3 February 2009
The Canadian Network for Mood and Anxiety Treatments (CANMAT) published guidelines for the management of bipolar disorder in 2005, with a 2007 update. This second update, in conjunction with the International Society for Bipolar Disorders (ISBD), reviews new evidence and is designed to be used in conjunction with the previous publications.
The recommendations for the management of acute mania remain mostly unchanged. Lithium, valproate, and several atypical antipsychotics continue to be first-line treatments for acute mania. Tamoxifen is now suggested as a third-line augmentation option. The combination of olanzapine and carbamazepine is not recommended. For the management of bipolar depression, lithium, lamotrigine, and quetiapine monotherapy, olanzapine plus selective serotonin reuptake inhibitor (SSRI), and lithium or divalproex plus SSRI/bupropion remain first-line options. New data support the use of adjunctive modafinil as a second-line option, but also indicate that aripiprazole should not be used as monotherapy for bipolar depression. Lithium, lamotrigine, valproate, and olanzapine continue to be first-line options for maintenance treatment of bipolar disorder. New data support the use of quetiapine monotherapy and adjunctive therapy for the prevention of manic and depressive events, aripiprazole monotherapy for the prevention of manic events, and risperidone long-acting injection monotherapy and adjunctive therapy, and adjunctive ziprasidone for the prevention of mood events.
Bipolar II disorder is frequently overlooked in treatment guidelines, but has an important clinical impact on patients’ lives. This update provides an expanded look at bipolar II disorder.