The information used in this resource is based on the most up-todate, best available evidence. Key studies and reviews are listed below. A clinician or local librarian can assist you to access this information.
All information on the effectiveness of treatment options at preventing relapse is sourced from meta-analyses of randomised controlled trials (RCTs), which are considered the highest possible level of evidence.
The medication treatments presented in this resource (lithium, lamotrigine and quetiapine) are all recommended as first-line treatments for relapse prevention in bipolar II disorder in up-to date clinical guidelines. This means that the medical establishment generally accepts all these medications as appropriate for initial treatment. Information on the potential risks or side effects of medication options is sourced from well-designed RCTs or largescale naturalistic (population-based) studies.
The psychological treatments presented in this resource (cognitive behavioural therapy and group psycho-education) are both supported by Level 1 Evidence in up-to-date clinical guidelines on bipolar disorder. This is considered the highest possible level of evidence, which comes from a systematic review of RCTs.
Beynon S, Soares-Weiser K, Woolacott N, Duffy S, Geddes JR. Psychosocial interventions for the prevention of relapse in bipolar disorder: systematic review of controlled trials. The British Journal of Psychiatry. 2008;192(1):5-11.
Calabrese JR, Bowden CL, Sachs G, Yatham LN, Behnke K, Mehtonen O-P, et al. A placebo-controlled 18-month trial of lamotrigine and lithium maintenance treatment in recently depressed patients with bipolar I disorder. The Journal of Clinical Psychiatry. 2003;64(9):1013-24.
Colom F, Vieta E, Martinez-Aran A, Reinares M, Goikolea JM, Benabarre A, et al. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Archives of General Psychiatry. 2003;60(4):402-7.
Fisher A, Manicavasagar V, Sharpe L, Laidsaar-Powell R, Juraskova I. A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder. The Journal of Mental Health. Published online 13 January 2017.
Grunze H, Vieta E, Goodwin GM, Bowden C, Licht RW, MÃ¶ller H-J, et al. The World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the biological treatment of bipolar disorders: update 2012 on the long-term treatment of bipolar disorder. The World Journal of Biological Psychiatry. 2013;14(3):154-219.
Judd LL, Akiskal HS, Schettler PJ, Coryell A, Endicott J, Maser J, et al. A prospective investigation of the natural history of the longterm weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry. 2003;60(3):261-269.
Lam DH, Watkins ER, Hayward P, Bright J, Wright K, Kerr N, et al. A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. Archives of General Psychiatry. 2003;60(2):145-52.
Malhi GS, Bassett D, Boyce P, Bryant R, Fitzgerald PB, Fritz K, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders. Australian and New Zealand Journal of Psychiatry. 2015;49(12):1087-206.
McElroy SL, Weisler RH, Chang W, Olausson B, Paulsson B, Brecher M, et al. A double blind, placebo-controlled study of quetiapine and paroxetine as monotherapy in adults with bipolar depression (EMBOLDEN II). Journal of Clinical Psychiatry. 2010;71(2):163.
Miura T, Noma H, Furukawa TA, Mitsuyasu H, Tanaka S, Stockton S, et al. Comparative efficacy and tolerability of pharmacological treatments in the maintenance treatment of bipolar disorder: a systematic review and network meta-analysis. The Lancet Psychiatry. 2014;1(5):351-9.
Oud M, Mayo-Wilson E, Braidwood R, et al. (2016) Psychological interventions for adults with bipolar disorder: systematic review and meta-analysis. The British Journal of Psychiatry 208(3): 213- 222.
Suppes T, Marangell LB, Bernstein IH, Kelly DI, Fischer EG, Zboyan HA, et al. A single blind comparison of lithium and lamotrigine for the treatment of bipolar II depression. Journal of Affective Disorders. 2008;111(2):334-43.
Swartz HA, Swanson J. Psychotherapy for Bipolar Disorder in Adults: A Review of the Evidence. FOCUS. 2014.
Yatham LN, Kennedy SH, Parikh SV, Schaffer A, Beaulieu S, Alda M, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disorders. 2013;15(1):1-44.
Young AH, McElroy SL, Bauer M, Philips N, Chang W, Olausson B, et al. A double-blind, placebo-controlled study of quetiapine and lithium monotherapy in adults in the acute phase of bipolar depression (EMBOLDEN I). The Journal of Clinical Psychiatry. 2010;71(2):150-62.
Young AH, McElroy SL, Olausson B, Paulsson B. A randomised, placebo-controlled 52-week trial of continued quetiapine treatment in recently depressed patients with bipolar I and bipolar II disorder. The World Journal of Biological Psychiatry. 2014;15(2):96-112.