CLINICAL TRIALSThe bipolar affective disorder: lithium anticonvulsant comparative evaluation (BALANCE) trial compared lithium plus valproate with either drug alone in 330 patients with bipolar disorder type 1. Patients were recruited from 41 sites in UK, France and Italy.
The risk of relapse was 40% lower in patients allocated to combination therapy with lithium plus valproate than in those on valproate monotherapy.
The DSM-IV is produced by the American Psychiatric Association and provides criteria for the classification of mental disorders.
The RCGP covers this topic in statement 13 Care of People with Mental Health Problems.
- Manic Depression Fellowship - The Bipolar Organisation www.mdf.org.uk
The website of the leading patient organisation focusing on bipolar disorder, previously known as the Manic Depression Fellowship.
The main patient information site of the NHS also includes links to Map of Medicine, which includes care pathways.
- NICE. Bipolar disorder. CG38. 2006
This clinical guideline provides a comprehensive, evidence-based overview of the management of bipolar disorder. www.nice.org.uk
- The British Association for Psychopharmacology guideline
This provides a comprehensive, up-to-date overview of general management and pharmacological treatment. www.bap.org.uk/pdfs/Bipolar_guidelines.pdf
Contributed by Professor John Geddes, Professor of Epidemiological Psychiatry at the Warneford Hospital, Oxford