INTRODUCTION

The Canadian Network for Mood and Anxiety Treatments (CANMAT) is a group of clinicians, teachers and researchers from across Canada with a special interest in promoting education, evidence based practice and research in depression, bipolar disorder and anxiety disorders.

The Bipolar Sub-Committee of CANMAT is promoting or co-ordinating training modules and preceptorship training programs for psychiatrists, family physicians and other mental health professionals in addition to encouraging multicentre research in Bipolar Disorder. This group has also conducted an extensive and intensive study of evidence based practice in Bipolar Disorder. This evidence and an expert group’s recommendations will be the basis of a special series of articles on the Treatment of Bipolar Disorder: Guidelines and Options. This will be published after independent peer review later in 1997.

This monograph is a summary of clinical issues and treatment options in Bipolar Disorder and is directed towards psychiatrists, other mental health professionals and family practitioners in a variety of settings. The treatment algorithms were a result of deliberations by an expert group reviewing published work and clinical practice as well as extensive consultations with over 150 psychiatrists and family practitioners from across Canada.

This CANMAT publication is intended to give clinicians a handy summary of many of the major clinical issues and treatment options, particularly psychopharmacological treatment, in Bipolar Disorder in order to expand the knowledge and scope of their practice. It is not intended to be a reference book, a "cookbook" for treatment or a substitute for good clinical judgment and practice. These are not protocols or guidelines. The reader is provided with some relevant, not exhaustive, list of references placed close to blocks of text.

Patients with bipolar disorder often present with complex clinical issues, ranging from comorbid conditions like alcohol and substance abuse, personality and relationship dysfunction to breakdown in scholastic or work functioning. The authors recommend that a vast array of treatment and rehabilitative interventions are often needed. While recognising that healthy therapeutic relationships and systematic psychosocial interventions are the cornerstone of good management, the authors acknowledge that the details of these issues are beyond the scope of this monograph. And, needless to say, with exciting new advances in treatment of Bipolar Disorder on the horizon, such a publication will have to be updated periodically to make it relevant to contemporary practice.

Vivek Kusumaker, MD, FRCPC
Chair, Bipolar Sub-Committee
Canadian Network for Mood and Anxiety Treatments (CANMAT)