brainscanNICE has issued new draft guidance proposing to recommend aripiprazole for treating moderate to severe manic episodes in adolescents aged 13 and older with bipolar I disorder.

Commenting on the draft guidance, Professor Carole Longson, Director, Centre for Health Technology Evaluation, said. “Bipolar disorder is a serious mental health condition which is characterised by episodes of mania and depression. During a manic episode, the young person usually experiences irritability, poor concentration, little need for sleep and poor temper control. They may also feel over-confident and be driven to take unnecessary risks.

“Acute manic episodes not only have a huge impact on the young person in terms of school, work and social life, but also on those around them - particularly their family or carers. Because of this it is really important that manic episodes are treated quickly and effectively so that young people and their families can return to normal in terms of schooling, work and family life as quickly as possible.”

NICE has already published a clinical guideline on the overall management of bipolar disorder in adults, children and adolescents. This new draft guidance focuses on the use of aripiprazole for the specific treatment of moderate to severe manic episodes in adolescents.

Professor Longston continued: “As aripiprazole works at least as well as the existing treatment, our independent appraisal committee now recommends it as an option for treating moderate to severe manic episodes in adolescents with bipolar I disorder.”

The independent Committee decided that an appraisal consultation document was not needed for this appraisal, so the recommendations could go straight to final draft or final appraisal determination. This happens when the Committee recommends a treatment in line with its licensed indication. The draft guidance is now with consultees, who have the opportunity to appeal against it.

Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments. Once NICE issues its final guidance on a technology, it replaces local recommendations across the country.