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,
Yatham
LN, et al. Canadian
Network for Mood andor
Anxiety
Treatments
(CANMAT)
guidelines
for the management
of
lithiun
or
divalproex
AAP
+
TCA,
lithium
or
patients with bipolar disorder: consensus and controversies, Bipolar Disorders 2005: 7 (Suppl 3):5-69.
divalproex or carbamazepine + SSRI +

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,

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.
omega-3-fatty acids, oxcarbazepine, or

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
Yatham
LN, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of
monotherapy.
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.