CANMAD 2007

Sasanto Wibisono Jakarta 16 Oktober 2010

Didukung Kumpulan Slides Eli Lilly (SA)

CANMAT 2007 Guidelines

(Canadian Network for Mood and Anxiety Treatments)

Recommendations for treatment of Acute Bipolar Mania Lithium, divalproex, olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone; lithium or divalproex + risperidone, quetiapine or olanzapine. Carbamazepine, oxcarbazepine, ECT, or lithium + divalproex. Haloperidol, chlorpromazine, lithium or divalproex + haloperidol, lithium + carbamazepine, clozapine. Not recommended: monotherapy with gabapentin, topiramate,
lamitrigine, verapamiltiagabine, risperidone + carbamazepine.

Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.

CANMAT 2007 Guidelines (cont.)

(Canadian Network for Mood and Anxiety Treatments)

Recommendations for treatment of Acute BP I Depression: Lithium, lamptrigine, lithium or divalproex + SSRI, olanzapine + SSRI, lithium + divalproex, lithium or divalproex + bupropion, quetiapine monotherapy. Quetiapine + SSRI, lithium or divalproex + lamitrigine. Carbamazepine, olanzapine, divalproex, lithium + carbamazepine, lithium + pramipexole, lithium or divalproex + venlavaxine, lithium + MAOI, ECT, lithiun or divalproex or AAP + TCA, lithium or divalproex or carbamazepine + SSRI + lamotrigine, adjunctive EPA, adjunctive rinuzole, adjunctive topiramate. Not recommended: monotherapy with gabapentin.

Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.

CANMAT 2007 Guidelines (cont.)

Recommendations for maintenance therapy of BP disorder: Lithium, lamotrigine monotherapy (mainly for those with mild manias), divalproex, olanzapine. Carbamazepine, lithium + divalproex, lithium + carbamazepine, lithium or divalproex + olanzapine, aripiprazole, risperidone, quetiapine, ziprasidone, lithium + risperidone or quetiapine, lithium + lamotrigine or SSRI or bupropion, olanzapine + fluoxetine. Adjunctive phenytoin, clozapine, topiramate, omega-3-fatty acids, oxcarbazepine, or gabapentin. Not recommended: adjunctive flupenthixol, monotherapy with gabapentin, topiramate or antidepressants

Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.

CANMAT 2007 Guidelines (cont.)

Pharmacological maintenance treatment of BP disorder with rapid cycling: Lithium, divalproex. Lithium + divalproex, lithium + carbamazepine, lithium or divalproex + lamotrigine, olanzapine. Lithium or divalproex + topiramate, quetiqpine, risperidone, clozapine, oxcarbazepine, levothyroxine. Not recommended: antidepressants
Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.

CANMAT 2007 Guidelines (cont.)

Recommendations for treatment of acute BP II depression: Insufficient evidence. Lithium, lamotrigine, lithium or divalproex + antidepressants, lithium + divalproex, atypical antipsychotics + antidepressants, quetiapine. Switch to alternate antidepressant. Not recommended: see text on antidepressants for recommendations regarding antidepressant monotherapy.

Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.

CANMAT 2007 Guidelines (cont.)

Recommendations for maintenance treatment of BP II disorder: Lithium, lamotrigine. Divalproex, lithium or divalproex or atypical antipsychotic + antidepressant, combination of 2 of: lithium, lamotrigine, divalproex, or atypical antipsychotic. Cabamazepine, atypical antipsychotic, ECT. Not recommended: gabapentin.
Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.