{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T20:09:57Z","timestamp":1790021397000,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,7,2]],"date-time":"2020-07-02T00:00:00Z","timestamp":1593648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004330","name":"GlaxoSmithKline","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004330","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The aim of this study was to develop a consensus guideline by certified experts of the Japanese Society of Clinical Neuropsychopharmacology on the psychopharmacological treatment for bipolar disorders I and II (BP\u2010I and BP\u2010II), in order to fill the gap in the literature and provide more concrete guidance for challenging and controversial real\u2010world situations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Experts were asked to assess treatment options regarding 19 clinical situations of bipolar disorder with a nine\u2010point Likert scale (one\u00a0=\u00a0\u201cdisagree\u201d and nine\u00a0=\u00a0\u201cagree\u201d). According to the responses from 119 experts, the options were categorized into the first\u2010, second\u2010, and third\u2010line treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the treatment of BP\u2010I, lithium monotherapy was categorized as a first\u2010line treatment for manic episodes (mean\u00a0\u00b1\u00a0standard deviation score, 7.0\u00a0\u00b1\u00a02.2), depressive episodes (7.1\u00a0\u00b1\u00a02.0), and the maintenance phase (7.8\u00a0\u00b1\u00a01.8). Combination therapy of lithium and an atypical antipsychotic was endorsed for manic episodes (7.7\u00a0\u00b1\u00a01.7), depressive episodes with (7.1\u00a0\u00b1\u00a02.0) and without mixed features (6.9\u00a0\u00b1\u00a02.2), and the maintenance phase (6.9\u00a0\u00b1\u00a02.1). Similarly, in BP\u2010II, lithium monotherapy was categorized as a first\u2010line treatment for hypomanic episodes (7.3\u00a0\u00b1\u00a02.2), depressive episodes (7.0\u00a0\u00b1\u00a02.2), and the maintenance phase (7.3\u00a0\u00b1\u00a02.3), while combination therapy of lithium and an atypical antipsychotic was recommended for hypomanic episodes (6.9\u00a0\u00b1\u00a02.4).No antipsychotic monotherapy or antidepressant treatment was categorized as a first\u2010line treatment for any type of episode.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These recommendations reflect the current evidence and represent the experts' consensus on using lithium for the treatment of bipolar disorder. Clinicians should consider the effectiveness and adverse effects of antipsychotic and antidepressant medications for the treatment of bipolar disorder.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12959","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T22:40:05Z","timestamp":1592433605000},"page":"822-830","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Pharmacological management of bipolar disorder: Japanese expert consensus"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5399-7946","authenticated-orcid":false,"given":"Hitoshi","family":"Sakurai","sequence":"first","affiliation":[{"name":"Department of Psychiatry Massachusetts General Hospital  Boston MA USA"},{"name":"Department of Neuropsychiatry Keio University School of Medicine  Tokyo 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