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Guía de práctica clínica para el manejo del trastorno bipolar: actualización 2025
Vikas Menon1, Ragul Ganesh1, Raman Deep2
1Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Indian journal of psychiatry
|February 16, 2026
Resumen
Esta guía actualiza el manejo del trastorno bipolar (TB) en adultos con un enfoque específico para cada fase y tratamientos escalonados. Aborda el trastorno bipolar II y consideraciones especiales para mejorar la práctica clínica.
Área de la Ciencia:
- Psiquiatría
- Guías clínicas
- Manejo del trastorno bipolar
Sus antecedentes:
- Las guías anteriores de la Sociedad Psiquiátrica de la India para el trastorno bipolar (TB) se publicaron en 2017 (adultos) y 2019 (niños/adolescentes).
- Los avances significativos en el manejo del TB exigen recomendaciones actualizadas.
Objetivo del estudio:
- Resumir los principales avances en el manejo del TB desde publicaciones anteriores.
- Proporcionar un enfoque de tratamiento práctico, específico para cada fase y escalonado para los médicos.
- Abordar las necesidades específicas del trastorno bipolar II y las consideraciones especiales de tratamiento en el contexto de la India.
Principales métodos:
- Revisiones estructurales de la guía de 2017 para mejorar la utilidad clínica.
- Adopción de un enfoque específico para cada fase (manía, depresión, episodios mixtos) con algoritmos.
- Clasificación de los tratamientos en primera, segunda y tercera línea según la eficacia, tolerabilidad, disponibilidad y asequibilidad.
- Inclusión de secciones dedicadas al trastorno bipolar II, consideraciones especiales de tratamiento y consenso de expertos.
Principales resultados:
- Una guía revisada y fácil de usar que incorpora una estrategia de tratamiento por fases y escalonada.
- Discusión detallada sobre el manejo de comorbilidades, adherencia, polifarmacia, clozapina, tratamientos emergentes, inyectables de acción prolongada y seguridad reproductiva.
- Inclusión de consenso de expertos sobre dilemas clínicos comunes en el manejo del TB.
- Uso extensivo de tablas y diagramas de flujo para facilitar la comprensión y adopción.
Conclusiones:
- La guía actualizada promueve la toma de decisiones informada por la evidencia en el manejo del trastorno bipolar.
- Los cambios estructurales y el contenido integral tienen como objetivo mejorar la práctica clínica y los resultados de los pacientes.
- La guía proporciona un marco práctico para el manejo de varias fases y tipos de trastorno bipolar.
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