What are the consensus treatment guidelines for bipolar disorder?

The consensus guidelines for bipolar disease are prepared by a panel of psychiatrists who are experts in their field. These experts completed a survey concerning psychopharmacologic interventions used in specific clinical situations. The guidelines, reflecting the aggregate opinions of panel members, lay out a recommended treatment approach.

The 2000 consensus guidelines for the pharmacologic treatment of bipolar disorder make the following key points:

  • Mood stabilizers are the treatment of choice for patients with bipolar disorder.
  • If monotherapy fails, combination therapy should be used.
  • Bipolar disorder is a chronic illness.
  • Adjunctive use of atypical antipsychotics is recommended for mania or depression with psychosis — this may change with emerging data and clinical experience.
  • Antidepressants may be used in conjunction with a mood stabilizer to treat concomitant depressive disorders.

It is important to note that recent studies suggest that atypical antipsychotics, in addition to their benefits in reducing psychotic symptoms, may play a role as mood stabilizers.