Table 7.
Level of Recommendation during the Maintenance Phase and the Efficacy in the Prevention of Manic, Mixed, or Depressive Episodes as Well as Recommended Dosages
| Agent/modality | Monotherapy | Combination | Recommended dosage | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Manic | depressive | Mixed | MS | Cbz | Lam | Li | Val | ||
| Quetiapine | 2 | 2 | - | 1 | - | - | - | - | 300–800 mg/d |
| Olanzapine | 2 | 2 | 2 | 4 | - | - | - | - | 5–20 mg/d |
| Lithium | 2 | 3 | - | - | - | - | - | - | 0.6–1.2 mEq/L |
| Lamotrigine | 4 | 4 | - | - | - | - | - | - | 50–400 mg/d |
| Psychoeducation | - | - | -- | 3 | - | - | - | - | |
| Aripiprazole | 1 | 5 | - | 2 | - | 5 | - | 5 | 10–30 mg/d |
| RLAI | 1 | 5 | - | 2 | - | - | - | - | 25–50 mg/biweekly |
| Paliperidone | 2 | 5 | - | - | - | - | - | - | 3–12 mg/d |
| Valproate | 4 | 3 | - | - | - | - | - | - | 45–100 mg/L |
| Carbamazepine | 4 | 4 | - | - | - | - | - | - | 4–12 mg/L |
| Ziprasidone | - | - | - | 4 | - | - | - | - | 80–160 mg/d |
| Fluoxetine | - | 2 | - | - | - | - | - | - | 10–40 mg/d |
| CBT | - | - | - | 2 | - | - | - | - | |
| Phenytoin | - | - | - | 2 | - | - | - | - | Mean studied 380 mg/d (blood levels 10 microgram/mL) |
| Paroxetine | - | - | - | 3 | - | - | - | - | 20 mg/d |
| N-acetyl cysteine | - | - | - | 4 | - | - | - | - | 2 g/d |
| Imipramine | 5 | 5 | - | - | - | - | 5 | - | |
| Memantine | - | - | - | 5 | - | - | - | - | |
| Oxcarbazepine | - | - | - | - | - | - | 5 | - | |
| Perphenazine | - | - | - | 5 | - | - | - | - | |
Abbreviations: CBT, cognitive behavioral therapy; Cbz, carbamazepine; Lam, lamotrigine; MS, mood stabilizer; RLAI, risperidone long acting injection; Val, valproate.
The grading method including the levels of recommendation are described in detail in the 1st and 2nd papers on CINP treatment guidelines, which are included in the current supplement.