Troubles bipolaires: mise à jour 2015 : recommandations thérapeutiques de la Société Suisse des Troubles Bipolaires (SSTB)

This article summarizes the treatment recommendations for Bipolar disorders developed by the Swiss Society of Bipolar Disorders. It is an update of our recommendation published in 2011. They are based on evidence from randomizedcontrolled studies, international treatment guidelines and observational studies. Although the most solid evidence exists for pharmacotherapy, a bio-psycho-social treatment approach including psycho-education and psychotherapy is required to achieve optimal treatment outcomes for patients with Bipolar Disorder. Group psychoeducation, internet psychoeducation and supported employment have been included as evidence-based psychosocial interventions. The recommendations are largely unchanged. For acute mania, lithium, valproate, several atypical antipsychotics and their combinations remain the first-line treatment options; asenapine and paliperidone have been added to the list of recommended atypical antipsychotics. Quetiapine and lithium and newly lamotrigine are recommended for Bipolar Depression as well as combinations of mood stabilizing drugs with SSRI or bupropion. In 2013, lurasidone was approved for Bipolar depression in the USA. First-line options for maintenance treatment of Bipolar Disorder are lithium, quetiapine, lamotrigine (the latter predominately for prevention of depression), valproate, olanzapine, aripiprazole (the latter for prevention of mania only) and lithium or valproate combined with quetiapine. Aripirazole, risperidone und lamotrigine have been added as add-on options in the maintenance treatment. The guidelines include recommendations regarding safety monitoring of pharmacological treatment