International therapeutic guidelines for bipolar disorder

Aims This article reviews 3 recent treatment guidelines for bipolar disorder, looking at similarities and differences and trying to provide some useful advice on the treatment of bipolar patients based on guidelines input. Methods Publications included in PubMed under the heading of 'guidelines' and 'bipolar disorder' were reviewed. We selected 3 on the basis of providing expert consensus, having an international panel, and being updated up to 2004. Results The Expert Consensus Guidelines for the treatment of bipolar disorder, the International Consensus Group on bipolar I depression guidelines, and the Canadian Network for Mood and Anxiety treatment guidelines for the management of patients with bipolar disorders provide useful advise on the treatment of manic-depressive illness. Their recommendations are mostly evidence-based and include lithium, valproate, and antipsychotics (preferably atypicals) for the treatment of mania and lithium or larnotrigine for the treatment of bipolar depression. Some advice is also provided for maintenance treatment and difficult-to-treat patients. Conclusions Treatment guidelines for bipolar disorder may be useful and are quite consistent, with the caveat that they run quickly out-of-date due to the speedy progress in this area in recent years.