Executive Summary
1. Executive Summary
Mental health disorders are a leading cause of disability in the Philippines, affecting millions of
Filipinos and contributing significantly to the national burden of disease. According to the World
Health Organization, as of 2017, an estimated 3.3 million Filipinos live with depressive disorders
and 3 million with anxiety disorders—figures that have likely increased in the wake of the
COVID-19 pandemic. Schizophrenia and bipolar disorder, while less prevalent, cause profound
functional impairment and long-term disability.
In response to this growing public health concern, the Philippine Psychiatric Association (PPA),
in collaboration with the National Center for Mental Health (NCMH), updated its 2017
Consensus Treatment Guidelines. This 2025 Clinical Treatment Guideline (CTG) provides
evidence-based, context-specific recommendations on the pharmacologic management of
adults with anxiety disorders, depressive disorders, bipolar disorder, and schizophrenia.
This guideline addresses 12 priority questions covering four major psychiatric conditions, with a
focus solely on pharmacologic interventions. It provides therapeutic recommendations for acute
treatment, relapse prevention, and maintenance phases. The recommendations are based on a
structured review of clinical evidence, contextual factors, patient values, and resource
availability in the Philippine setting.
The guideline was developed by a multidisciplinary team composed of psychiatrists, clinical
epidemiologists, methodologists, patient advocates, and primary care representatives. A de
novo process was used following the 2018 DOH Manual for Clinical Practice Guideline
Development and the GRADE (Grading of Recommendations Assessment, Development and
Evaluation) approach. Current best available evidence for each topic was synthesized through a
systematic literature review and evaluated for certainty. Recommendations were formulated
over 4 online consensus meetings held from March 20-22, 2025. The strength of each
recommendation was classified as strong or weak/conditional, based on a transparent
assessment of benefits, harms, certainty of evidence, feasibility, cost, and values/preferences.
As a result of this deliberative process, 13 recommendations were made (Table 1). This CTG is
primarily intended for psychiatrists and psychiatric residents-in-training, but may also be used by
primary care physicians, mental health professionals, and health institutions involved in treating
individuals with the prioritized mental health disorders. Patients and the public are indirect
beneficiaries of this CTG, as its implementation is expected to promote equitable, affordable,
and effective care across the country.
