Korean J Psychopharmacol.
2014 Oct;25(4):161-167. 10.0000/kjp.2014.25.4.161.
Korean Medication Algorithm for Bipolar Disorder 2014: Safety and Tolerability
- Affiliations
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- 1Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea.
- 2Department of Psychiatry, Jeju National University Hospital, Jeju, Korea.
- 3Department of Psychiatry, Haeundae Paik Hospital and Paik Institute for Clinical Research, College of Medicine, Inje University, Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea.
- 4Department of Psychiatry, Naju National Hospital, Naju, Korea.
- 5Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
- 6Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea.
- 7Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wmbahk@catholic.ac.kr
- 8Department of Psychiatry, Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Korea.
- 9Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea.
- 10Department of Psychiatry, Chung-Ang University Hospital, College of Medicine, Chung-Ang University, Seoul, Korea.
- 11Department of Psychiatry, Sacred Heart Hospital, College of Medicine, College of Medicine, Hallym University, Anyang, Korea. cogni@naver.com
- KMID: 2287763
- DOI: http://doi.org/10.0000/kjp.2014.25.4.161
Abstract
OBJECTIVE
The complexity of the treatment for bipolar disorder is often caused by the presence of side effects of various psychiatric medications. In particular, weight gain and metabolic syndrome are currently major concerns in the medication for bipolar disorders. Therefore, we undertook a survey of expert opinion to help make clinical decisions in these special situations.
METHODS
A written survey which asked about treatment strategies in the safety and tolerability was prepared; 1) weight gain, 2) antipsychotic related hyperprolactinemia, 3) lamotrigine related skin rash, 4) treatment non-adherence, and 5) genetic counselling. Treatment options were scored using a 9-point scale for rating appropriateness of clinical decisions in some issues. In other issues, experts were asked to choose to determine the ranking of preferences on the list. Sixty-four experts of the review committee completed the survey. We classified the expert opinions about preferences by chi2 test.
RESULTS
Experts preferred behavioral and diet modification for weight gain, switching to prolactin-sparing-antipsychotics for antipsychotic-induced hyperprolactinemia, reducing dose of lamotrigene for its related benign skin rash, and prescribing once a day for treatment adherence.
CONCLUSION
With the limitation of expert opinion, authors hope that the results of this study provide valuable information to make clinical decision about the treatment of bipolar disorder in the complicated situations.
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