Korean J Psychopharmacol.
2011 Oct;22(4):171-182.
Korean Medication Algorithm for Bipolar Disorder 2010: Comparisons with Other Treatment Guidelines
- Affiliations
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- 1Naju National Hospital, Naju, Korea.
- 2Department of Psychiatry, Yeouido St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea. wmbahk@catholic.ac.kr
- 3Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea.
- 4Department of Psychiatry, College of Medicine, Inje University, Seoul, Korea.
- 5Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
- 6Stress Clinic, Health Promotion Center, Asan Medical Center, Seoul, Korea.
- 7Department of Psychiatry, College of Medicine, Inje Universtiy Haeundae Paik Hospital and Paik Institute for Clinical Research, Busan, Korea.
- 8Department of Psychiatry, College of Medicine, Konkuk University, Chungju, Korea.
- 9Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea.
- 10Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Korea.
- 11Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea.
- 12Department of Psychiatry, Gwangju Mirae Hospital, Gwangju, Korea.
- 13Department of Psychiatry, College of Medicine, Hallym University, Anyang, Korea.
Abstract
- The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed in 2002 and thereafter revised in 2006. It was secondly revised in 2010 (KMAP-BP 2010). The aim of this study was to compare KMAP-BP 2010 with other recently published treatment algorithm and guidelines for bipolar disorder. The authors reviewed the 4 recently published guidelines and treatment algorithms for bipolar disorder [The British Association for Psychopharmacology Guideline for Treatment of Bipolar Disorder, Canadian Network for Mood and Anxiety Treatments Guidelines for the Management of Patients with Bipolar Disorder, The World Federation Society of Biological Psychiatry Guideline for Biological Treatment of Bipolar Disorder and National Institute for Health and Clinical Experience (NICE) Clinical Guideline] to compare the similarities and discrepancies between KMAP-BP 2010 and the others. In aspects of treatment options, most treatment guidelines had some similarities. But there were notable discrepancies between the recommendations of other guidelines and those of KMAP-BP in which combination or adjunctive treatments were favored. Most guidelines advocated new atypical antipsychotics as first-line treatment option in nearly all phases of bipolar disorder and lamotrigine in depressive phase and maintenance phase. Lithium and valproic acid were still commonly used as mood stabilizers in manic phase and strongly recommended valproic acid in mixed or psychotic mania. Mood stabilizers or atypical antipsychotics were selected as first-line treatment option in maintenance treatment. As the more evidences were accumulated, more use of atypical antipsychotics such as quetiapine, aripiprazole and ziprasidone were prominent. This review suggests that the medication strategies of bipolar disorder have been reflected the recent studies and clinical experiences, and the consultation of treatment guidelines may provide clinicians with useful information and a rationale for making sequential treatment decisions. It also has been consistently stressed that treatment algorithm or guidelines are not a substitute for clinical judgment; they may serve as a critical reference to complement of individual clinical judgment.
MeSH Terms
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Antipsychotic Agents
Anxiety
Biological Psychiatry
Bipolar Disorder
Complement System Proteins
Dibenzothiazepines
Humans
Judgment
Lithium
Piperazines
Psychopharmacology
Quinolones
Thiazoles
Triazines
Valproic Acid
Aripiprazole
Quetiapine Fumarate
Antipsychotic Agents
Complement System Proteins
Dibenzothiazepines
Lithium
Piperazines
Quinolones
Thiazoles
Triazines
Valproic Acid
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