CLINICAL PRACTICE GUIDELINES FORTHE MANAGEMENT OF BIPOLAR AFFECTIVE (MOOD) DISORDERS Document prepared by : Dr. Ajit Avasthi, Dr. Suresh Kumar and Dr. Ashis Vikas, Department of Psychiatry, PGIMER, Chandigarh IPS GUIDELINE COMMITTEE ON BIPOLAR AFFECTIVE DISORDERS

Bipolar Affective [Mood] Disorders are a class of psychiatric disorders that are the most distressing either from the point of view of patients [as in depressive phase] or from that of the caregivers [as in manic counterpart].These disorders have potential remission inbuilt in their defining criteria [American Psychiatric Association, 2000; World Health Association, 2002].They also are recognized as the psycho-behavioral disorders that are the most well studied ones from the point of view of efficacy of pharmacotherapy. Lithium Carbonate was the first drug that demonstrated its therapeutic and prophylactic potential against recurring Bipolar Affective [Mood] Disorder. Over the years, many new molecules have been examined regarding their thymoleptic properties and a huge literature has gathered. In the other vein, data regarding individual-based and family-based psycho-social interventions have also accumulated. There is a compelling need to review all such data to see where we stand as far as global scientific database is concerned. Simultaneously, we also need to see from the point of view of our country i.e. whether and how our unique circumstances suggest any differences to be considered in management of Bipolar Affective [Mood] Disorders in India. The foregoing introduction summarizes the intention of this review. It should be emphasized that observations and opinions made in this review are only general guidelines and the exact and the best treatment strategies in an individual case have to be based on a number of considerations unique to that case. Further, the data reviewedprincipally pertain to the pharmacological management and refers to the adult population unless specified otherwise. The abbreviation 'BPAD' has been repeatedly used in this paper to represent the term 'Bipolar Affective Disorders'.