The method chosen for these guidelines is a formalized consensus of experts. It enables, through a series of specific clinical situations proposed to the experts, to provide recommendations for the management of bipolar disorder. The situations where defined because they are not associated to evidence-based recommendations according to the lack of controlled studies.

40 experts participate to this consensus. As in most of the guidelines for the treatment of bipolar disorder, more than 50 % of experts (51,3 to 72,9%) recommend the same therapeutic strategies to treat major depressive episode whichever the type (bipolar I or II).

Unlike to other guidelines, French experts propose different therapeutic according to the presence or absence of rapid cycling. For major depressive episode without rapid cycling, 63% experts recommend a combination of an antidepressant with a mood stabilizer. In rapid cyclers, 51% experts recommend the use of a mood stabilizer in monotherapy or in combinaison, but never associated with antidepressant.

This methodological approach enables to get closer to everyday clinical practice and integrate specificities of prescription through a national panel of experts. On the other hand, this type of methodology highlights the research perspectives: i.e. management of acute depression with rapid cycle in bipolar disorder.