This guideline covers recognising, assessing and treating bipolar disorder (formerly known as manic depression) in children, young people and adults. The recommendations apply to bipolar I, bipolar II, mixed affective and rapid cycling disorders. It aims to improve access to treatment and quality of life in people with bipolar disorder.
MHRA advice on valproate: In April 2018, we added warnings that valproate must not be used in pregnancy, and only used in girls and women when there is no alternative and a pregnancy prevention plan is in place. This is because of the risk of malformations and developmental abnormalities in the baby. See update information for details. In March 2019, we produced a summary of NICE guidance to support the safe use of valproate.
This guideline includes recommendations on:
- recognising and managing bipolar disorder in adults in primary care
- assessing suspected bipolar disorder in adults in secondary care
- managing mania, hypomania and bipolar depression in secondary care
- managing bipolar disorder in the longer term in secondary care
- promoting recovery and return to primary care
- recognising, diagnosing and managing bipolar disorder in children and young people
Who is it for?
- Healthcare professionals
- People working in occupational health, social services and the independent sector
- Children, young people and adults with bipolar disorder
- Families of and people who care for children, young people and adults with bipolar disorder
Is this guideline up to date?
We checked this guideline in October 2017. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline updates and replaces NICE guideline CG38 (July 2006).
This guideline was previously called bipolar disorder: the assessment and management of bipolar disorder in adults, children and young people in primary and secondary care.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.