NICE CG185 Bipolar

Bipolar disorder: assessment and management (NICE guideline CG185)

CG185 keeps lithium as the first-line long-term treatment for bipolar disorder — a position it has held through the 2025 update — with valproate avoided in women of childbearing potential and antidepressant monotherapy discouraged. Alongside the pharmacology it recommends a structured psychological intervention designed for bipolar disorder for people in remission or with mild depressive symptoms. The register trials below cover that psychosocial arm: family-focused therapy, CBT as an adjunct, and intensive psychotherapy for bipolar depression.

This guideline cites 4 of the 62 landmark trials in our Psychiatry & psychotherapy register.

Source
National Institute for Health and Care Excellence. Bipolar disorder: assessment and management. NICE guideline [CG185]. Published 24 September 2014; last updated 2 September 2025.

Family-focused therapy1

  • 2003Miklowitz FFTPsychiatry · Bipolar · Family-focused therapyFamily-Focused Therapy in Bipolar Disorder

CBT as an adjunct to pharmacotherapy2

  • 2006Scott CBTPsychiatry · Bipolar · CBT add-onPragmatic CBT Trial in Bipolar Disorder
  • 2003Lam CBTPsychiatry · Bipolar · CBT add-onCognitive Therapy Adjunct in Bipolar Disorder

Intensive psychotherapy for bipolar depression1

  • 2007STEP-BD PsyPsychiatry · Bipolar · Intensive psychotherapyIntensive Psychosocial Intervention in Bipolar Disorder