The International Society for Bipolar Disorders (ISBD) consensus guidelines for the safety monitoring of bipolar disorder treatments.
OBJECTIVE
Safety monitoring is an important aspect of bipolar disorder treatment, as mood-stabilising medications have potentially serious side effects, some of which may also aggravate existing medical comorbidities. This paper sets out the International Society for Bipolar Disorders (ISBD) guidelines for the safety monitoring of widely used agents in the treatment of bipolar disorder. These guidelines aim to provide recommendations that take into consideration the balance between safety and cost-effectiveness, to highlight iatrogenic and preventive clinical issues, and to facilitate the broad implementation of therapeutic safety monitoring as a standard component of treatment for bipolar disorder.


METHODS
These guidelines were developed by an ISBD workgroup, headed by the senior author (MB), through an iterative process of serial consensus-based revisions. After this, feedback from a multidisciplinary group of health professionals on the applicability of these guidelines was sought to develop the final recommendations.


RESULTS
General safety monitoring recommendations for all bipolar disorder patients receiving treatment and specific monitoring recommendations for individual agents are outlined.


CONCLUSIONS
These guidelines are derived from evolving and often indirect data, with minimal empirical cost-effectiveness data available to provide guidance. These guidelines will therefore need to be modified to adapt to different clinical settings and health resources. Clinical acumen and vigilance remain critical ingredients for safe treatment practice.
Ng
Felicity
F
Discipline of Psychiatry, School of Medicine, University of Adelaide, SA, Australia.
Mammen
Oommen K
OK
Wilting
Ingeborg
I
Sachs
Gary S
GS
Ferrier
I Nicol
IN
Cassidy
Frederick
F
Beaulieu
Serge
S
Yatham
Lakshmi N
LN
Berk
Michael
M
D018692:Antimanic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D032921:Consensus; D006801:Humans; D008991:Monitoring, Physiologic / Q000592:standards*; D012958:Societies, Scientific
D018692:Antimanic Agents