title: The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder.
abstract: OBJECTIVE
  These guidelines are based on a first edition that was published in 2004, and have been edited and updated with the available scientific evidence up to October 2012. Their purpose is to supply a systematic overview of all scientific evidence pertaining to the long-term treatment of bipolar disorder in adults.
  
  
  METHODS
  Material used for these guidelines are based on a systematic literature search using various data bases. Their scientific rigor was categorised into six levels of evidence (A-F) and different grades of recommendation to ensure practicability were assigned.
  
  
  RESULTS
  Maintenance trial designs are complex and changed fundamentally over time; thus, it is not possible to give an overall recommendation for long-term treatment. Different scenarios have to be examined separately: Prevention of mania, depression, or an episode of any polarity, both in acute responders and in patients treated de novo. Treatment might differ in Bipolar II patients or Rapid cyclers, as well as in special subpopulations. We identified several medications preventive against new manic episodes, whereas the current state of research into the prevention of new depressive episodes is less satisfactory. Lithium continues to be the substance with the broadest base of evidence across treatment scenarios.
  
  
  CONCLUSIONS
  Although major advances have been made since the first edition of this guideline in 2004, there are still areas of uncertainty, especially the prevention of depressive episodes and optimal long-term treatment of Bipolar II patients.
authors.affiliation: Newcastle University, Institute of Neuroscience, Newcastle upon Tyne, UK. Heinz.Grunze@ncl.ac.uk
authors.forename: Heinz
authors.initials: H
authors.lastname: Grunze
authors.forename: Eduard
authors.initials: E
authors.lastname: Vieta
authors.forename: Guy M
authors.initials: GM
authors.lastname: Goodwin
authors.forename: Charles
authors.initials: C
authors.lastname: Bowden
authors.forename: Rasmus W
authors.initials: RW
authors.lastname: Licht
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Möller
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000209:etiology / Q000517:prevention & control*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D018692:Antimanic Agents / Q000008:administration & dosage / Q000009:adverse effects; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy*; D019468:Disease Management; D004565:Electroconvulsive Therapy / Q000379:methods; D019317:Evidence-Based Medicine; D006801:Humans; D008134:Long-Term Care / Q000379:methods / Q000458:organization & administration; D054539:Medication Therapy Management; D008991:Monitoring, Physiologic / Q000379:methods; D016032:Randomized Controlled Trials as Topic
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents