Bipolar disorder guideline registry¶
Last verified: 2026-09-03
This registry catalogs documents; synthesis and clinical comparison belong in wiki/guidelines.md. “Current” means no superseding document was identified in this session, not that every recommendation remains current.
Master table¶
| Body | Year | Region | Scope | Citation / live source | Status at 2026-08-31 |
|---|---|---|---|---|---|
| CANMAT / ISBD | 2018 | Canada / international | Comprehensive bipolar management | Yatham et al., PMID 29536616 | Current base document; supplemented by 2023 update |
| CANMAT / ISBD | 2023 | Canada / international | Summary and evidence update | Keramatian et al., PMID 38695002 | Current supplement; not a complete section-by-section replacement |
| CANMAT / ISBD | 2021 | Canada / international | Mixed presentations | Yatham et al., PMID 34599629 | Topic supplement; DSM-5 recommendations lower-ranked than older DSM-IV mixed-episode recommendations |
| NICE CG185 | 2014, updated 2025 | England and Wales | Recognition, acute and long-term management, children and adults | https://www.nice.org.uk/guidance/cg185, accessed 2026-08-30 | Current; page states last updated 2 Sep 2025 |
| VA / DoD | 2023 | United States | Adult bipolar management | https://healthquality.va.gov/HEALTHQUALITY/guidelines/mh/bd/index.asp, accessed 2026-08-30; synopsis PMID 39832345 | Current US federal guideline |
| APA | 2002 | United States | Comprehensive treatment | https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-1410197656063.pdf, accessed 2026-08-30 | Historical; hosted PDF explicitly says it cannot be assumed current |
| APA Guideline Watch | 2005 | United States | New evidence after 2002 guideline | https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/bipolar-watch-1410457042123.pdf, accessed 2026-08-30 | Historical supplement |
| British Association for Psychopharmacology | 2016 | United Kingdom | Evidence-based biological and psychosocial treatment | Goodwin et al., PMID 26979387 | Current BAP bipolar edition found; aging |
| RANZCP | 2020 | Australia / New Zealand | Mood disorders including bipolar disorder | Malhi et al., PMID 33353391; https://www.ranzcp.org/clinical-guidelines-publications/clinical-guidelines-publications-library/mood-disorders-cpg, accessed 2026-08-30 | Society labels it >5 years old and no longer current |
| CINP | 2017 | International | Methods, evidence grading, algorithm and clinical guidance | PMIDs: 27815414, 27816941, 27941079 | Current CINP bipolar series found; aging |
| WFSBP | 2013 | International | Long-term biological treatment | Grunze et al., PMID 23480132 | Topic-specific; aging |
| WFSBP | 2018 | International | Acute and long-term mixed states | Grunze et al., PMID 29098925 | Topic-specific current document found |
| JSMD | 2023 / English paper 2024 | Japan | Practice guideline: pharmacotherapy, psychosocial, perinatal, monitoring | Kato et al., PMID 39194164; https://www.secretariat.ne.jp/jsmd/iinkai/katsudou/kibun.html, accessed 2026-08-30 | Current; supersedes JSMD 2020 treatment guideline |
| Japanese Society of Clinical Neuropsychopharmacology | 2020 | Japan | Pharmacological expert consensus | Sakurai et al., PMID 32558145 | Supplementary expert consensus; not the current JSMD practice guideline |
| Chinese guideline | 2018 | China | Principal assessment and management summary | Wang et al., PMID 29604156 | Latest PubMed-indexed national summary found; currency unconfirmed |
| Indian Psychiatric Society | 2025 update / paper 2026 | India | Adult bipolar management | Menon et al., PMID 41694044 | Current adult update; supersedes 2017 adult document |
| Indian Psychiatric Society | 2017 | India | Adult bipolar management | Shah et al., PMID 28216785 | Superseded by 2025 update |
| Indian Psychiatric Society | 2019 | India | Child and adolescent bipolar disorder | Gautam et al., PMID 30745704 | Pediatric topic document |
| Taiwan consensus | 2022 / paper 2023 | Taiwan | Acute, maintenance and mixed phases | Cheng et al., PMID 36724568 | Current update found |
| Korean Medication Algorithm Project | 2018 edition / comparison 2020 | South Korea | Expert medication algorithm | Jon et al., PMID 32202033 | Fifth edition described; check for newer edition |
| CANMAT/WFSBP taskforce | 2022 | International | Nutraceuticals/phytoceuticals across psychiatric disorders | Sarris et al., PMID 35311615 | Special-purpose adjunct, not core bipolar guideline |
| International expert consensus | 2016 | International | Psychiatric agitation including bipolar disorder | Garriga et al., PMID 26912127 | Special-purpose emergency adjunct |
| ACOG | 2023 | United States | Mental-health treatment during pregnancy/postpartum | ACOG, PMID 37486661 | Current reproductive-health adjunct |
| ACOG | 2023 | United States | Perinatal screening and diagnosis, including bipolar disorder and postpartum psychosis | ACOG, PMID 37486660 | Current; modified GRADE plus ungraded good-practice points |
| AWMF S3 / BipolarLiving | Update registered 2025 | Germany | Diagnosis and treatment | https://www.awmf.org/aktuelles/awmf-aktuell/diagnostik-und-therapie-bipolarer-stoerungen-bipolarliving, accessed 2026-08-30 | Prior guideline validity ended 31 May 2026; version 2.1 update project registered, not yet a completed replacement |
Per-guideline notes¶
CANMAT / ISBD 2018 and 2023¶
- Full citation: Yatham LN, et al. Canadian Network for Mood and Anxiety Treatments and International Society for Bipolar Disorders 2018 guidelines for the management of patients with bipolar disorder. Bipolar Disord. 2018;20:97-170. PMID 29536616.
- Scope: diagnosis, acute mania, bipolar depression, maintenance and special populations.
- Contribution: integrated hierarchical recommendations combining efficacy, safety/tolerability and clinical experience.
- Update relationship: Keramatian et al. summarize the 2018 framework and update evidence through 2023; use both rather than treating the shorter paper as a wholesale replacement (PMID 38695002).
- Status: current core international reference in this registry.
- Mixed-presentations supplement: no agent reached first line for DSM-5 mania or depression with mixed features; second-line options were asenapine, cariprazine, divalproex and aripiprazole for mania, and cariprazine and lurasidone for depression. DSM-IV mixed episodes retained first-line asenapine/aripiprazole because the evidence populations differ (Yatham et al., PMID 34599629).
NICE CG185¶
- Title: Bipolar disorder: assessment and management.
- Published 24 September 2014; official page reports last update 2 September 2025.
- Scope: bipolar I, bipolar II, mixed affective and rapid-cycling disorders in children, young people and adults.
- Distinctive structure: recognition/referral, crisis and risk, physical-health monitoring and UK service pathways.
- URL: https://www.nice.org.uk/guidance/cg185 (accessed 2026-08-30).
- Status: current; retain version date with every extracted recommendation.
VA / DoD 2023¶
- Official title: Management of Bipolar Disorder (BD) (2023).
- Official source: https://healthquality.va.gov/HEALTHQUALITY/guidelines/mh/bd/index.asp (accessed 2026-08-30).
- Published synopsis: Ostacher MJ, et al. J Clin Psychiatry. 2025;86:24cs15546. PMID 39832345.
- Primary-care summary: Arnold MJ. Am Fam Physician. 2024;109:585-587. PMID 38905567.
- Status: current US federal guideline; evidence grading resides in the full CPG.
APA 2002 and 2005 Guideline Watch¶
- The official hosted 2002 second-edition PDF states that it is more than five years old and cannot be assumed current.
- The 2005 Guideline Watch adds evidence but explicitly is not a formal full update.
- Chain: APA 2002 → supplemented by 2005 Guideline Watch → no current replacement verified.
- Status: historical/provenance only; do not use as a current recommendation without newer corroboration.
British Association for Psychopharmacology 2016¶
- Full citation: Goodwin GM, et al. Evidence-based guidelines for treating bipolar disorder: revised third edition. J Psychopharmacol. 2016;30:495-553. PMID 26979387.
- Official BAP page: https://www.bap.org.uk/docdetails.php?docID=6 (accessed 2026-08-30).
- Scope: acute and long-term pharmacologic and psychosocial treatment.
- Chain: earlier BAP editions → 2016 revised third edition.
- Status: influential and not superseded on the BAP page found, but aging.
RANZCP 2020¶
- Full citation: Malhi GS, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Aust N Z J Psychiatry. 2021;55:7-117. PMID 33353391.
- Official page states the guideline is more than five years old and “no longer considered current guidance.”
- Chain: 2015 mood-disorders CPG → 2020 update → replacement pending.
- Status: historical/recent reference, not current by issuing society's own label.
CINP-BD 2017¶
- Part 1: background and methods. PMID 27815414.
- Part 2: systematic review, evidence grading and algorithm. PMID 27816941.
- Part 3: clinical guidelines. PMID 27941079.
- The three papers are one package; citing only Part 3 loses the grading method.
- Status: latest CINP bipolar guideline series found; aging.
WFSBP topic guidelines¶
- Long-term treatment update 2012, published 2013: Grunze et al., PMID 23480132.
- Mixed states, acute and long term, published 2018: Grunze et al., PMID 29098925.
- These are topic documents, not one current comprehensive bipolar guideline.
- Status: use for their declared topics and preserve publication year.
Japanese Society of Mood Disorders¶
- Official society page lists the 2023 Practice Guideline for Bipolar Disorder and an English version.
- English indexed article: Kato T, et al. Psychiatry Clin Neurosci. 2024;78:633-645. PMID 39194164.
- Chain: 2011 initial treatment guideline → revisions through June 2020 → 2023 practice guideline.
- Status: current Japanese society guideline.
China, India, Taiwan and South Korea¶
- China: the 2018 principal summary is PubMed-indexed (Wang et al., PMID 29604156); full-document current status needs a national-site check.
- India: the adult 2025 update (Menon et al., PMID 41694044) supersedes the 2017 adult document; the child/adolescent 2019 guideline remains a separate pediatric topic document (Gautam et al., PMID 30745704).
- Taiwan: 2022 consensus update covers acute, maintenance and mixed phases (Cheng et al., PMID 36724568).
- South Korea: the 2020 paper traces changes across 16 years and five KMAP-BP editions (Jon et al., PMID 32202033); search for a sixth edition at next sweep.
Disagreements and gaps¶
| Issue | Document-level disagreement / gap |
|---|---|
| Bipolar-depression sequencing | International comparison finds less agreement than for mania; newer antipsychotics and local licensing shift rankings (Parker et al., PMID 28260229; Park et al., PMID 38586960) |
| Adjunctive antidepressants | Guidelines vary in how narrowly they permit use, but antidepressant monotherapy in bipolar I is broadly rejected |
| Maintenance ranking | Lithium remains central; relative placement of antipsychotics, lamotrigine and valproate depends on polarity and safety weighting |
| Mixed features | WFSBP and Taiwan have explicit mixed-state frameworks; definitions and evidence populations differ across eras |
| Mixed-feature grading | CANMAT/ISBD assigns no first-line agent to DSM-5 mixed presentations, but assigns first-line asenapine/aripiprazole to DSM-IV mixed episodes; phenotype definition changes the evidence tier (PMID 34599629) |
| Rapid cycling | NICE applies the same interventions because of insufficient evidence for a separate pathway; other algorithms discuss additional cautions |
| Reproductive risk | National regulator restrictions evolve faster than full psychiatric guideline cycles; ACOG and current regulator material must supplement older documents |
| Evidence-grade visibility | ACOG labels modified-GRADE recommendations and ungraded good-practice points; older qualitative guideline systems such as BAP use different evidence-strength categories, so ranks are not directly interchangeable (PMIDs: 37486660, 19329543) |
| Children/adolescents | Far fewer trials; adult recommendations cannot be assumed transferable |
| Biomarkers/digital phenotyping | A live 2026-08-30 search of retrieved guideline texts found no routine molecular, polygenic or passive-sensing diagnostic/treatment-selection rule; the 2025 Indian update discusses internet-based self-management but notes limited real-world evidence |
| Patient-important harms | Cognition, sexual function, work and monitoring burden are inconsistently weighted |
| Implementation | Guideline concordance and access to recommended psychotherapy/monitoring remain separate from recommendation quality |
Superseded and supplement chains¶
| Chain | Registry interpretation |
|---|---|
| CANMAT earlier editions → CANMAT/ISBD 2018 → supplemented by 2023 evidence update | Use 2018 detail plus 2023 update |
| NICE predecessor guidance → CG185 2014 → amendments through 2025 | Use live recommendation page and version date |
| APA 2002 → 2005 Guideline Watch → no replacement verified | Historical only |
| BAP earlier editions → 2016 third edition | 2016 is latest BAP bipolar document found |
| RANZCP 2015 → RANZCP 2020 → replacement pending | 2020 explicitly not current per society |
| JSMD 2011 → JSMD 2020 revision → JSMD 2023 practice guideline | 2023 is current |
| Taiwan earlier consensus → 2022 update (published 2023) | Use 2022 update |
| KMAP-BP five editions through 2018 | Check for post-2018 edition |
| Indian Psychiatric Society adult 2017 → 2025 update (published 2026) | Use 2025 update for adult management; retain 2017 for provenance |
| German AWMF prior S3 guideline → version 2.1 update registered May 2025 | Prior validity ended 31 May 2026; await completed replacement |
Watch list¶
- New APA bipolar guideline replacing the 2002/2005 documents.
- Full CANMAT/ISBD replacement or new focused updates after 2023.
- NICE surveillance changes after the September 2025 update.
- Replacement RANZCP mood-disorders guideline.
- New BAP bipolar edition after 2016.
- Updated WFSBP long-term guideline after the 2013 publication.
- New CINP algorithm after 2017.
- New Chinese national full guideline and English summary.
- Implementation evidence and revisions following the Indian 2025 adult update.
- Sixth or later Korean Medication Algorithm Project edition.
- Regulatory changes for valproate and other reproductive-risk medicines in each region.
- Any guideline adoption of digital prediction, biomarker testing or patient-governed monitoring.
- Completion of the registered German AWMF S3/BipolarLiving version 2.1 update.
Search provenance¶
PubMed E-utilities searches in this session included bipolar disorder with guideline/guidelines/consensus title terms; targeted WFSBP, CINP, British, Japanese, Korean, Indian, Chinese, Australian and VA/DoD terms; records were confirmed by ESummary/EFetch. Official pages for NICE, VA/DoD, APA, BAP, RANZCP, CANMAT, JSMD and AWMF were fetched or web-retrieved live on 2026-08-30. The Indian 2025 adult update was found in the re-search and verified as PMID 41694044 by live ESearch and EFetch.
A 2026-08-31 re-check of NICE CG185, VA/DoD 2023, BAP, RANZCP, JSMD, CANMAT and AWMF BipolarLiving pages found no completed replacement documents. The sole PubMed title-term guideline hit with a print date after 2026-08-28 was an MDD anhedonia consensus (PMID 42314447), indexed June 2026 and not a bipolar practice guideline. APA psychiatryonline.org returned HTTP 403.
On 2026-09-03, five targeted live PubMed E-utilities searches re-examined CANMAT, NICE, VA/DoD, BAP and ACOG positions. The mixed-presentations CANMAT/ISBD supplement (PMID 34599629), NICE methods critique (PMID 26853311), historical BAP grading document (PMID 19329543), ACOG screening/diagnosis guideline (PMID 37486660) and historical CANMAT 2007 update (PMID 17156158) were added to make grading systems, phenotype-dependent ranks and supersession explicit. This pass did not claim that historical documents are current.