Bipolar disorder: assessment and management (CG185)

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.

Valproate: In September 2024, the Medicines and Healthcare products Regulatory Agency (MHRA) published a Drug Safety Update on valproate use in men and their partners. Effective contraception (condoms, plus contraception used by the female sexual partner) is recommended throughout the valproate treatment period and for 3 months after stopping valproate. See the MHRA’s advice for healthcare professionals. NICE is assessing the impact of this alert on recommendations in this guideline.

Recommendations on valproate in this guideline are in line with the MHRA guidance on valproate use by women and girls and Drug Safety Update on the risks associated with valproate in men and women under 55. For more details see update information.

Last reviewed: 30 July 2024

We simplified the guideline by removing recommendations on general principles of care that are covered in other NICE guidelines (for example, the NICE guideline on service user experience in adult mental health). This is a presentational change only, and no changes to practice are intended.

This guideline updates and replaces NICE guideline CG38 (July 2006).

Next review: This guidance will be reviewed if there is new evidence that is likely to change the recommendations.