Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations

Lakshmi N. Yatham; Trisha Chakrabarty; David J. Bond; Ayal Schaffer; Serge Beaulieu; Sagar V. Parikh; Roger S. McIntyre; Roumen V. Milev; Martin Alda; Gustavo Vazquez; Arun V. Ravindran; Benicio N. Frey; Verinder Sharma; Benjamin I. Goldstein; Soham Rej; Claire O’Donovan; Valerie Tourjman; Jan Marie Kozicky; Marcia Kauer-Sant’Anna; Gin Malhi; Trisha Suppes; Eduard Vieta; Flavio Kapczinski; Shigenobu Kanba; Raymond W. Lam; Sidney H. Kennedy; Joseph Calabrese; Michael Berk; Robert Post

doi:10.1111/bdi.13135

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations

Lakshmi N. Yatham, Trisha Chakrabarty, David J. Bond, Ayal Schaffer, Serge Beaulieu, Sagar V. Parikh, Roger S. McIntyre, Roumen V. Milev, Martin Alda, Gustavo Vazquez, Arun V. Ravindran, Benicio N. Frey, Verinder Sharma, Benjamin I. Goldstein, Soham Rej, Claire O’Donovan, Valerie Tourjman, Jan Marie Kozicky, Marcia Kauer-Sant’Anna, Gin MalhiTrisha Suppes, Eduard Vieta, Flavio Kapczinski, Shigenobu Kanba, Raymond W. Lam, Sidney H. Kennedy, Joseph Calabrese, Michael Berk, Robert Post

Medicine

Résultat de recherche: Article › examen par les pairs

51 Citations (Scopus)

Résumé

Objectives: The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided—a critical gap which the current update aims to address. Method: Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high-quality data and reliance on expert opinion. Results: No agents met threshold for first-line treatment of DSM-5 manic or depressive episodes with mixed features. For mania + mixed features second-line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second-line options. For DSM-IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first-line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second-line. Research on maintenance treatments following a DSM-5 mixed presentation is extremely limited, with third-line recommendations based on expert opinion. For maintenance treatment following a DSM-IV mixed episode, quetiapine (monotherapy or combination) is first-line, and lithium and olanzapine identified as second-line options. Conclusion: The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.

Langue d'origine	English
Pages (de-à)	767-788
Nombre de pages	22
Journal	Bipolar Disorders
Volume	23
Numéro de publication	8
DOI	https://doi.org/10.1111/bdi.13135
Statut de publication	Published - déc. 2021

Note bibliographique

Funding Information:
The authors would like to thank Dee Bass, Kayhan Ghatavi, and Michael Rosenbluth for their insightful feedback on a draft version of the manuscript.

Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

ASJC Scopus Subject Areas

Psychiatry and Mental health
Biological Psychiatry

PubMed: MeSH publication types

Journal Article
Practice Guideline
Review

ODD de l’ONU

Cette action contribue à la réalisation des objectifs de développement durable suivants

Accès au document

10.1111/bdi.13135

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Citer

Yatham, L. N., Chakrabarty, T., Bond, D. J., Schaffer, A., Beaulieu, S., Parikh, S. V., McIntyre, R. S., Milev, R. V., Alda, M., Vazquez, G., Ravindran, A. V., Frey, B. N., Sharma, V., Goldstein, B. I., Rej, S., O’Donovan, C., Tourjman, V., Kozicky, J. M., Kauer-Sant’Anna, M., ... Post, R. (2021). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations. Bipolar Disorders, 23(8), 767-788. https://doi.org/10.1111/bdi.13135

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations. / Yatham, Lakshmi N.; Chakrabarty, Trisha; Bond, David J. et al.
Dans: Bipolar Disorders, Vol. 23, N° 8, 12.2021, p. 767-788.

Résultat de recherche: Article › examen par les pairs

Yatham, LN, Chakrabarty, T, Bond, DJ, Schaffer, A, Beaulieu, S, Parikh, SV, McIntyre, RS, Milev, RV, Alda, M, Vazquez, G, Ravindran, AV, Frey, BN, Sharma, V, Goldstein, BI, Rej, S, O’Donovan, C, Tourjman, V, Kozicky, JM, Kauer-Sant’Anna, M, Malhi, G, Suppes, T, Vieta, E, Kapczinski, F, Kanba, S, Lam, RW, Kennedy, SH, Calabrese, J, Berk, M & Post, R 2021, 'Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations', Bipolar Disorders, vol. 23, n° 8, pp. 767-788. https://doi.org/10.1111/bdi.13135

@article{a5b04ce1f8a04d0db1f804a670834e09,

title = "Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations",

abstract = "Objectives: The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided—a critical gap which the current update aims to address. Method: Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high-quality data and reliance on expert opinion. Results: No agents met threshold for first-line treatment of DSM-5 manic or depressive episodes with mixed features. For mania + mixed features second-line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second-line options. For DSM-IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first-line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second-line. Research on maintenance treatments following a DSM-5 mixed presentation is extremely limited, with third-line recommendations based on expert opinion. For maintenance treatment following a DSM-IV mixed episode, quetiapine (monotherapy or combination) is first-line, and lithium and olanzapine identified as second-line options. Conclusion: The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.",

author = "Yatham, {Lakshmi N.} and Trisha Chakrabarty and Bond, {David J.} and Ayal Schaffer and Serge Beaulieu and Parikh, {Sagar V.} and McIntyre, {Roger S.} and Milev, {Roumen V.} and Martin Alda and Gustavo Vazquez and Ravindran, {Arun V.} and Frey, {Benicio N.} and Verinder Sharma and Goldstein, {Benjamin I.} and Soham Rej and Claire O{\textquoteright}Donovan and Valerie Tourjman and Kozicky, {Jan Marie} and Marcia Kauer-Sant{\textquoteright}Anna and Gin Malhi and Trisha Suppes and Eduard Vieta and Flavio Kapczinski and Shigenobu Kanba and Lam, {Raymond W.} and Kennedy, {Sidney H.} and Joseph Calabrese and Michael Berk and Robert Post",

note = "Funding Information: The authors would like to thank Dee Bass, Kayhan Ghatavi, and Michael Rosenbluth for their insightful feedback on a draft version of the manuscript. Publisher Copyright: {\textcopyright} 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd",

year = "2021",

month = dec,

doi = "10.1111/bdi.13135",

language = "English",

volume = "23",

pages = "767--788",

journal = "Bipolar Disorders",

issn = "1398-5647",

publisher = "Blackwell Munksgaard",

number = "8",

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TY - JOUR

T1 - Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) recommendations for the management of patients with bipolar disorder with mixed presentations

AU - Yatham, Lakshmi N.

AU - Chakrabarty, Trisha

AU - Bond, David J.

AU - Schaffer, Ayal

AU - Beaulieu, Serge

AU - Parikh, Sagar V.

AU - McIntyre, Roger S.

AU - Milev, Roumen V.

AU - Alda, Martin

AU - Vazquez, Gustavo

AU - Ravindran, Arun V.

AU - Frey, Benicio N.

AU - Sharma, Verinder

AU - Goldstein, Benjamin I.

AU - Rej, Soham

AU - O’Donovan, Claire

AU - Tourjman, Valerie

AU - Kozicky, Jan Marie

AU - Kauer-Sant’Anna, Marcia

AU - Malhi, Gin

AU - Suppes, Trisha

AU - Vieta, Eduard

AU - Kapczinski, Flavio

AU - Kanba, Shigenobu

AU - Lam, Raymond W.

AU - Kennedy, Sidney H.

AU - Calabrese, Joseph

AU - Berk, Michael

AU - Post, Robert

N1 - Funding Information: The authors would like to thank Dee Bass, Kayhan Ghatavi, and Michael Rosenbluth for their insightful feedback on a draft version of the manuscript. Publisher Copyright: © 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

PY - 2021/12

Y1 - 2021/12

N2 - Objectives: The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided—a critical gap which the current update aims to address. Method: Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high-quality data and reliance on expert opinion. Results: No agents met threshold for first-line treatment of DSM-5 manic or depressive episodes with mixed features. For mania + mixed features second-line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second-line options. For DSM-IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first-line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second-line. Research on maintenance treatments following a DSM-5 mixed presentation is extremely limited, with third-line recommendations based on expert opinion. For maintenance treatment following a DSM-IV mixed episode, quetiapine (monotherapy or combination) is first-line, and lithium and olanzapine identified as second-line options. Conclusion: The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.

AB - Objectives: The 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) guidelines provided clinicians with pragmatic treatment recommendations for bipolar disorder (BD). While these guidelines included commentary on how mixed features may direct treatment selection, specific recommendations were not provided—a critical gap which the current update aims to address. Method: Overview of research regarding mixed presentations in BD, with treatment recommendations developed using a modified CANMAT/ISBD rating methodology. Limitations are discussed, including the dearth of high-quality data and reliance on expert opinion. Results: No agents met threshold for first-line treatment of DSM-5 manic or depressive episodes with mixed features. For mania + mixed features second-line treatment options include asenapine, cariprazine, divalproex, and aripiprazole. In depression + mixed features, cariprazine and lurasidone are recommended as second-line options. For DSM-IV defined mixed episodes, with a longer history of research, asenapine and aripiprazole are first-line, and olanzapine (monotherapy or combination), carbamazepine, and divalproex are second-line. Research on maintenance treatments following a DSM-5 mixed presentation is extremely limited, with third-line recommendations based on expert opinion. For maintenance treatment following a DSM-IV mixed episode, quetiapine (monotherapy or combination) is first-line, and lithium and olanzapine identified as second-line options. Conclusion: The CANMAT and ISBD groups hope these guidelines provide valuable support for clinicians providing care to patients experiencing mixed presentations, as well as further influence investment in research to improve diagnosis and treatment of this common and complex clinical state.

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