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Recommended first-line choices in the guideline from the Canadian Network for Mood and Anxiety Treatments (CANMAT) and the International Society for Bipolar Disorders (ISBD), The most recent authoritative international guideline for the management of patients with bipolar disorder by the CANMAT and the ISBD (2018) [12] recommends the following first-line drugs for bipolar depression: quetiapine, lithium, lamotrigine and lurasidone

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This may correlate with observations that anxiety, depression, and impaired olfaction are detectable in premotor stages of PD