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| 1 | 2018加拿大心境障碍与焦虑障碍治疗协作组/国际双相障碍学会指南:双相障碍的管理显示文摘加拿大心境障碍与焦虑障碍治疗协作组(Canadian Network for Mood and Anxiety Treatments,CANMAT)曾于2005年发布了第1版双相障碍管理指南,并分别于2007、2009和2013年对该指南进行了更新,其中最近的2次更新是与国际双相障碍学会(International Society for Bipolar Disorders,ISBD)合作完成。2018版CANMAT/ISBD双相障碍治疗指南(以下简称指南)反映了自2005年首版指南发表以来本领域取得的重大进展,包括疾病诊断与疾病管理的更新以及药物治疗与心理治疗的近期研究进展。这些前沿进展中综合考虑了循证证据的级别,并基于治疗疗效、临床实践经验、安全性、耐受性和药物导致的转相风险等,对一线、二线及三线治疗方案进行了简明而清晰的推荐。本指南中新增内容涵盖了双相Ⅰ型障碍(BD-Ⅰ)的躁狂发作急性期、抑郁发作急性期和双相障碍维持期的一线及二线治疗推荐等级划分。这种对治疗推荐等级的划分综合考虑了治疗方法对双相障碍不同时相的影响,将进一步帮助临床医生做出基于循证证据的治疗决策。锂盐、喹硫平、双丙戊酸盐、阿塞那平、阿立哌唑、帕利哌酮、利培酮和卡利拉嗪单药或联合使用被推荐为躁狂发作急性期的一线治疗选择。BD-Ⅰ抑郁期的一线治疗选择包括喹硫平、鲁拉西酮、锂盐、拉莫三嗪单药,鲁拉西酮联合锂盐或双丙戊酸盐或拉莫三嗪辅助治疗。尽管急性期治疗有效的药物通常应继续用于BD-Ⅰ的维持期治疗,但也存在一些特殊情况(例如抗抑郁药)。现有数据表明,锂盐、喹硫平、双丙戊酸盐、拉莫三嗪、阿塞那平和阿立哌唑单药或联合治疗应被视为维持治疗的初始或更换治疗方案时的一线选择。除了探讨BD-Ⅰ的相关问题外,本指南中还对双相Ⅱ型障碍(BD-Ⅱ)的临床管理进行了系统回顾并给予治疗推荐,同时针对特殊人群也有相关推荐,如处于各个生殖周期的女性、儿童、青少年和老年人。此外,本指南中还讨论了特定精神疾病及共病(如物质滥用、焦虑障碍和代谢性疾病)的影响。最后,本指南中概述了安全性和药物监测的相关问题。CANMAT/ISBD工作组希望本指南能够成为全球临床医生的实用工具。 | Lakshmi N Yatham Sidney H Kennedy Sagar V Parikh Ayal Sehaffer David J Bond Benicio N Frey Verinder Sharma Benjamin I Goldstein Soham Rej Serge Beaulieu Martin Alda Glenda MaeQueen Roumen V Milev Arun Ravindran Claire O'Donovan Diane Mclntosh Raymond W Lam Gustavo Vazquez Flavio Kapczinski Roger S Melntyre Jan Kozicky Shigenobu Kanba Beny Lafer Trisha Suppes Joseph R Calabrese Eduard Vieta Gin Malhi Robert M Post Michael Berk 胡晨(译) 王刚(译) | 2019 | 中华精神科杂志2019，52，1： | 25 |
| 2 | Canadian network for mood and anxiety treatments (CANMAT) and international society for bipolar disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder 显示文摘 | Yatham LN Kennedy SH Parikh SV | 2013 | Bipolar Disord2013，15，： | 1 |
| 3 | Newer anticonvulsants in the treatment of bipolar disorder显示文摘 | YATHAM LN | 2004 | J Clin Psychiatry2004，6510，1： | 1 |
| 4 | Quetiapine versus placebo in combination with lithium or divalproex for the treatment of bipolar mania显示文摘 | Yatham LN Paulsson B Muleen J | 2004 | J Clin Psychopharmacol2004，24，6： | 1 |
| 5 | The evolution of CANMAT Bipolar Disorder Guidelines:past,present,and future显示文摘 | Yatham LN Kennedy SH Parikh SV | 2013 | Bipolar Disord2013，15，1： | 1 |
| 6 | Oxcarbazepine in the treatment of bipolar disorder:a review显示文摘 | Pratoomsri W Yatham LM Bond DJ | 2006 | Can J Psychiatry2006，51，8： | 1 |
| 7 | Neuropsychological function in euthymic bipolar disorder: a meta - analysis 显示文摘 | Tones I J Boudreau VG Yatham LN | 2007 | Acta Psyehiatr Stand Supp12007，434，： | 1 |
| 8 | Mood stabilizers plus risperidone or placebo in the treatment of acute mania显示文摘 | Yatham LN Grossman F Augustyns I | 2003 | Br J Psychiatry2003，182，： | 1 |
| 9 | A clinical review of aripiprazole in bipolar de- pression and maintenance therapy of bipolar disorder显示文摘 | YATHAM L N | 2011 | J Af- fect Disord2011，128，1： | 1 |
| 10 | Brain serotonin2 receptors in major depression:a positron emission tomography study显示文摘 | Yatham LN Liddle PF Shiah IS | 2000 | Arch Gen Psychiatry2000，57，： | 1 |
| 11 | Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013 显示文摘 | Yatham LN Kennedy SH Parikh SV | 2013 | Bipolar Disord2013，15，1： | 1 |
| 12 | Oxcarbazepine in the treatment of bipolar disorder: a review 显示文摘 | Pratoomsri W Yatham LN Bond DJ | 2006 | Can J Psychiatry2006，51，8： | 1 |
| 13 | Canadian network for mood and anxiety treatments (CANMAT)and international society for bipolar disorders ( ISBD ) collaborative update of CANMAT guidelines for the management ofpatients with bipolar disorder:up- date 2009 显示文摘 | Yatham LN Kennedy SH Schaffer A | 2009 | Bipolar Disord2009，11，3： | 1 |
| 14 | Bipolar depression: criteria for treament selection, definition of refractoriness, and treatment options显示文摘 | Yatham LN Calabrese JR Kusumakar V | 2003 | Bipolar Disord2003，5，2： | 1 |
| 15 | A magnetic resonance imaging study of mood stabilizer and neuroleptic naive first epi- sode mania显示文摘 | Yatham L N Lyoo I K Liddle P | 2007 | Bipolar Disord2007，9，7： | 1 |
| 16 | The International Society tbr Bipolar Disorders-Battery for Assessment of Neurocognition ( ISBD- BANC) 显示文摘 | Yatham LN Torres !J Malhi GS | 2010 | Bipolar Disord2010，12，4： | 1 |
| 17 | Oxcarbazepine in the treatment of bipolar disorder:a review显示文摘 | Pratoomsri W Yatham LN Bond DJ | 2006 | Can J Psychiatry2006，51，8： | 1 |
| 18 | Canadian Network for Mood and Anxiety Treatments(CANMAT)guidelines for the management of patients with bipolar disorder:consensus and con- troversies显示文摘 | Yatham LN Kennedy SH O'Donovan C | | 0，，： | 1 |
| 19 | Atypical antipsychotics in bipolar depression: potential mechanisms of action 显示文摘 | Yatham LN Goldstein JM Vieta E | 2005 | J Clin Psyehintry2005，66，5： | 1 |
| 20 | A clinical review of aripiprazole in bipolar depression and maintenance therapy of bipolar disorder 显示文摘 | Yatham LN | 2011 | Journal of Affective Disorders2011，，： | 1 |
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