CANMAT and ISBD 2018 Guidelines for the Management of Bipolar Disorder

Oct 2, 2026

Uploaded by jay

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines present evidence-based recommendations for managing patients with bipolar disorder, building on updates since the prior 2005 edition. The document consolidates advances in diagnosis and treatment, translating findings into clear first-, second-, and third-line options with explicit consideration of evidence levels, clinical support, and consensus safety, tolerability, and treatment-emergent switch risk. New hierarchical rankings address acute mania, acute depression, and maintenance in bipolar I, and also cover bipolar II, specific populations, comorbidities, and safety monitoring.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages74

Reading Time3 h 6 min

AccessFree to download

Introduction

Overview of guideline advances

Evidence-based treatment recommendations

Bipolar disorder scope and populations

Comorbidities and safety monitoring

DOI: 10. 1111/bdi.12609 ORIGINAL ARTICLE Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder Lakshmi NYatham1 | Sidney H Kennedy2 | Sagar V Parikh3 | Ayal Schaffer2 | David J Bond4 | Benicio N Frey5 | Verinder Sharma6 | Benjamin I Goldstein2 | Soham Rej7 | Serge Beaulieu7 | Martin Alda8 | Glenda MacQueen9 | Roumen V Milev10 | Arun Ravindran2 | Claire O’Donovan8 | Diane McIntosh1 | Raymond W Lam1 | Gustavo Vazquez10 | Flavio Kapczinski5 | Roger S McIntyre2 Jan Kozicky11 | Shigenobu Kanba12 | Beny Lafer13 | Trisha Suppes14 | Joseph R Calabrese15 | Eduard Vieta16 | Gin Malhi17 | Robert M Post18 | Michael Berk19 1Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada 2Department of Psychiatry, University of Toronto, Toronto, ON, Canada 3Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA 4Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA 5Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada 6Departments of Psychiatry and Obstetrics & Gynaecology, Western University, London, ON, Canada 7Department of Psychiatry, McGill University, Montreal, QC, Canada 8Department of Psychiatry, Dalhousie University, Halifax, NS, Canada 9Department of Psychiatry, University of Calgary, Calgary, AB, Canada 10Departments of Psychiatry and Psychology, Queen’s University, Kingston, ON, Canada 11School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada 12Department of Neuropsychiatry, Kyushu University, Fukuoka, Japan 13Department of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil 14Bipolar and Depression Research Program, VA Palo Alto, Department of Psychiatry & Behavioral Sciences Stanford University, Stanford, CA, USA 15Department of Psychiatry, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA 16Bipolar Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain 17Department of Psychiatry, University of Sydney, Sydney, NSW, Australia 18Department of Psychiatry, George Washington University, Washington, DC, USA 19Deakin Univeristy, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia | Correspondence Lakshmi NYatham, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada. [Email: yatham@mail.ubc.ca](Email: yatham@mail.ubc.ca) Bipolar Disorders. 2018;20:97–[170. wileyonlinelibrary.com/journal/bdi](170. wileyonlinelibrary.com/journal/bdi) © 2018 John Wiley & Sons A/S. | 97 Published by John Wiley & Sons Ltd The Canadian Network for Mood and Anxiety Treatments (CANMAT) previously published treatment guidelines for bipolar disorder in 2005, along with international commentaries and subsequent updates in 2007, 2009, and 2013. The last two updates were published in collaboration with the International Society for Bipolar Disorders (ISBD) . These 2018 CANMAT and ISBD Bipolar Treatment Guidelines represent the significant advances in the field since the last full edition was published in 2005, including updates to diagnosis and management as well as new research into pharmacological and psychological treatments. These advances have been translated into clear and easy to use recommendations for first, second, and third-line treatments, with consideration given to levels of evidence for efficacy, clinical support based on experience, and consensus ratings of safety, tolerability, and treatment-emergent switch risk. New to these guidelines, hierarchical rankings were created for first and second-line treatments recommended for acute mania, acute depression, and maintenance treatment in bipolar I disorder. Created by considering the impact of each treatment across all

FAQs

What is new in the CANMAT and ISBD 2018 bipolar disorder guidelines?

The guidelines introduce hierarchical rankings for first- and second-line treatments across acute mania, acute depression, and maintenance in bipolar I disorder, plus updated recommendations reflecting advances since 2005.

How do the guidelines structure treatment recommendations?

Recommendations are organized into first-, second-, and third-line options, using evidence levels, clinical support based on experience, and consensus ratings of safety, tolerability, and switch risk.

Which bipolar disorder groups and patient populations are covered?

Beyond bipolar I, the guidelines provide an overview and recommendations for bipolar II and include advice for specific populations such as women across reproductive stages, children and adolescents, and older adults.

Oct 2, 2026

Uploaded by jay