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P282 Management Of Patients With Bipolar Disorder: An Adapted Clinical Practice Guideline >From King Saud University, King Khalid University Hospital, Clinical Practice Guidelines Committee, Faculty Of Medicine, Department Of Psychiatry
  1. E Abahussain1,2,4,
  2. S Fatani 2,4,5,
  3. M Altuwarigi1,2,4,
  4. L Al-Ansary2,4,6,
  5. Y Amer2,3,4
  1. 1Psychiatry Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  2. 2CPGs Committee and subcommittee, KSUHs, Riyadh, Saudi Arabia
  3. 3Quality Management Department, KSUHs, Riyadh, Saudi Arabia
  4. 4King Khalid University Hospital, Riyadh, Saudi Arabia
  5. 5Pharmacy Department, RiyadhSaudi Arabia Shaikh Bahamdan Chair for Evidence-Based Healthcare & Knowledge Translation, Riyadh Saudi Arabia

Abstract

Objectives Adaptation of CPGs for Treatment of Bipolar disorder in King Khalid University Hospital, Psychiatry Department

Methods The ADAPTE process for CPGs adaptation. Results: the final decision of the panel after full assessments of 3 source CPGs was full acceptance (adoption) of the 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 (updated 2009).

Results Examples of Recommendations Lithium, valproate, and several atypical antipsychotics monotherapy is recommended to be used as first line treatments for acute mania, combination pharmacology with antipsychotics and mood stabiliser can be used as first line option. Paliperidone monotherapy and asenapine alone or in combination with lithium or divalproex can be used as a second line treatment; tamoxifen is suggested as a third line augmentation option. 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 are first-line options. Adjunctive modafinil is recommended as a second-line option. lithium, lamotrigine, valoproate and olanzapine are first-line options for maintenance treatment of bipolar disorder.

Conclusion 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.

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