Journal Club #3: Bipolar Depression Guidelines: CANMAT & ISBD Versus Psychopharmacology Algorithm Project

The Psychopharmacology Algorithm Project at the Harvard South Shore Program: An Update on Bipolar Depression.

Article: Harv Rev Psychiatry. 2010 Jan-Feb;18(1):36-55. PubMed PMID: 20047460

This journal club will compare the following two guidelines for bipolar depression management:

1. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines.
2. Psychopharmacology Algorithm Project at the Harvard South Shore Program: An Update on Bipolar Depression (2019)

These guidelines will be compared in terms of First, Second, and Third-line treatment. This journal club will answer the following 10 clinically relevant questions:

1. Which medications are not recommended treatment for bipolar depression?
2. Which Non-FDA approved medication is the first-line treatment per both guidelines?
3. Which FDA approved treatment is not recommended by Harvard South Shore program update?
4. “Adjunctive” use of which medication is considered first-line treatment per CANMAT & ISBD guidelines?
5. Which one medication moved from second-line treatment (in CANMAT & ISBD) to first-line treatment (in Harvard South Shore program update)?
6. “Monotherapy” with which medication is considered third-line treatment per CANMAT & ISBD guideline?
7. Which medication(s) was recommended by CANMAT but NOT recommended by Harvard South Shore program update due to safety concerns?
8. Which antidepressant is preferred as an adjunctive treatment, over other antidepressants?
9. Does aripiprazole have efficacy as monotherapy or as an adjunct or no efficacy for bipolar depression?
10. Which non-medication option was recommended by both guidelines?