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National Collaborating Centre for Mental Health (UK). Bipolar Disorder: The NICE Guideline on the Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care. London: The British Psychological Society and The Royal College of Psychiatrists; 2014 Sep. (NICE Clinical Guidelines, No. 185.)

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  • April 2018: Footnotes and cautions have been added and amended to link to the MHRA's latest advice and resources on sodium valproate. Sodium valproate must not be used in pregnancy, and only used in girls and women when there is no alternative and a pregnancy prevention plan is in place. This is because of the risk of malformations and developmental abnormalities in the baby. November 2017: Footnotes for some recommendations were updated with current UK marketing authorisations and MHRA advice. Links to other guidelines have also been updated. Some research recommendations have been stood down. See these changes in the short version of the guideline.

April 2018: Footnotes and cautions have been added and amended to link to the MHRA's latest advice and resources on sodium valproate. Sodium valproate must not be used in pregnancy, and only used in girls and women when there is no alternative and a pregnancy prevention plan is in place. This is because of the risk of malformations and developmental abnormalities in the baby. November 2017: Footnotes for some recommendations were updated with current UK marketing authorisations and MHRA advice. Links to other guidelines have also been updated. Some research recommendations have been stood down. See these changes in the short version of the guideline.

Cover of Bipolar Disorder

Bipolar Disorder: The NICE Guideline on the Assessment and Management of Bipolar Disorder in Adults, Children and Young People in Primary and Secondary Care.

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APPENDIX 29Interventions for Children and Young People – Forest Plots

Abbreviations

CI

confidence interval

M-H

Mantel–Haenszel

SE

standard error

1.1. Pharmacological Interventions for Mania

1.1.1. Antipsychotics

Outcomes for antipsychotics compared with placebo

Response (50% reduction in manic symptoms) at post-treatment
Image app29f1
Symptoms of mania at post-treatment
Image app29f2
Number of participants withdrawing (for any reason)
Image app29f3
Number of participants withdrawing because of side effects
Image app29f4

Outcomes for antipsychotics compared with valproate

Response (50% reduction of manic symptoms) at post-treatment
Image app29f5
Symptoms of mania at post-treatment
Image app29f6
Number of participants withdrawing (for any reason)
Image app29f7
Number of participants withdrawing because of side effects
Image app29f8

1.1.2. Anticonvulsants

Outcomes for anticonvulsants compared with placebo

Response (50% reduction in manic symptoms) at post-treatment
Image app29f9
Symptoms of mania at post-treatment
Image app29f10
Number of participants withdrawing (for any reason)
Image app29f11
Number of participants withdrawing because of side effects
Image app29f12

Outcomes for anticonvulsants compared with valproate

Symptoms of mania at post-treatment
Image app29f13

1.1.3. Acute depression

Outcomes for quetiapine compared with placebo

Number of participants responding to treatment (50% reduction in depressive symptoms)
Image app29f14
Symptoms of depression at post-treatment
Image app29f15
Number of participants withdrawing (for any reason)
Image app29f16
Number of participants withdrawing because of side effects
Image app29f17
Outcomes for olanzapine and fluoxetine combination compared with placebo
Symptoms of depression at post-treatment
Image app29f18
Number of participants withdrawing (for any reason)
Image app29f19
Number of participants withdrawing because of side effects
Image app29f20

1.1.4. Psychological interventions

Outcomes for family focused therapy compared with TAU

Number of participants withdrawing (for any reason)
Image app29f21
© The British Psychological Society & The Royal College of Psychiatrists, 2014.

All rights reserved. No part of this guideline may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, or in any information storage or retrieval system, without permission in writing from the National Collaborating Centre for Mental Health. Enquiries in this regard should be directed to the Centre Administrator: ku.ca.hcyspcr@nimdAHMCCN

Bookshelf ID: NBK545946
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