Evidence-based guidelines for treating bipolar disorder: Revised third edition recommendations from the British Association for Psychopharmacology

Abstract

The British Association for Psychopharmacology guidelines specify the scope and targets of treatment for bipolar disorder. The third version is based explicitly on the available evidence and presented, like previous Clinical Practice Guidelines, as recommendations to aid clinical decision making for practitioners: it may also serve as a source of information for patients and carers, and assist audit. The recommendations are presented together with a more detailed review of the corresponding evidence. A consensus meeting, involving experts in bipolar disorder and its treatment, reviewed key areas and considered the strength of evidence and clinical implications. The guidelines were drawn up after extensive feedback from these participants. The best evidence from randomized controlled trials and, where available, observational studies employing quasi-experimental designs was used to evaluate treatment options. The strength of recommendations has been described using the GRADE approach. The guidelines cover the diagnosis of bipolar disorder, clinical management, and strategies for the use of medicines in short-term treatment of episodes, relapse prevention and stopping treatment. The use of medication is integrated with a coherent approach to psychoeducation and behaviour change.

British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017

“…Women with mental disorders are more likely to be smoking at conception, at antenatal booking, and up until delivery (Goodwin et al, 2007) and to find it more difficult to stop smoking, even if they accept referral to smoking cessation services (Howard et al, 2013). Smoking is associated with an increased risk of miscarriage, congenital malformations, low birth weight, prematurity, stillbirths, sudden infant death syndrome and physical and mental disorders in childhood (Royal College of Physicians, 2010).…”

Clinical effectiveness and acceptability of structured group psychoeducation versus optimised unstructured peer support for patients with remitted bipolar disorder (PARADES): a pragmatic, multicentre, observer-blind, randomised controlled superiority trial

“…It is a cheap, efficient and easy to deliver easy-toset-up option for mental health services because 10-18 participants can be treated at a time and therapists require supervision but not the extensive training required for other psychological treatments recommended for bipolar disorder. However, recently doubt has been expressed as to whether group psychoeducation, or indeed other psychological treatments, are really effective against bipolar relapse (12,13). A recent meta-analysis of the effectiveness of psychoeducation on bipolar relapse noted that the original Barcelona trials (8.…”

Psychoeducation as an Opportunity for Patients, Psychiatrists, and Psychiatric Educators: Why Do We Ignore It?

“…Psychoeducation and cognitive behavioral therapy are associated with increased time to mood episode relapse or recurrence [11,12]. Preliminary evidence shows that family psychoeducation for patients with depressive disorders improves patient functioning and the well-being of family caregivers [13].…”