Korean J Psychopharmacol.
2014 Apr;25(2):68-78.
Korean Medication Algorithm for Bipolar Disorder 2014: Depressive Episode
- Affiliations
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- 1Department of Psychiatry, Konkuk University Chungju Hospital, School of Medicine, Konkuk University, Chungju, Korea.
- 2Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wmbahk@catholic.ac.kr
- 3Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University and Paik Institute for Clinical Research, Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea.
- 4Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
- 5Department of Psychiatry, School of Medicine, Jeju Natinal University, Jeju, Korea.
- 6Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea.
- 7Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea.
- 8Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea.
- 9Department of Psychiatry, Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
- 10Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea.
- 11Department of Psychiatry, Naju National Hospital, Naju, Korea.
Abstract
OBJECTIVE
Since the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed in 2002, the third revision of KMAP-BP was performed in 2014 in order to reflect the recent rapid development and research of bipolar disorder and psychopharmacology.
METHODS
According to methodology of previous versions, KMAP-BP 2014 was revised using the same questionnaire consisting of 14 questions. Sixty-four experts of the review committee completed the survey. The executive committee analyzed the results and discussed the final production of algorithm considering scientific evidence.
RESULTS
The first-line pharmacotherapeutic strategy for acute bipolar depressive episode with moderate, non-psychotic severe and psychotic severe episode was mood stabilizer combined with atypical antipsychotic (AAP) or AAP with lamotrigine. Compared to KMAP-BP 2010, preference of AAP has been increased in the treatment of bipolar depressive episode in KMAP-BP 2014. Among AAPs, olanzapine, quetiapine and aripiprazole were preferred. When considering the efficacy and safety simultaneously, (es)citalopram, bupropion, and sertraline were recommended among antidepressants for bipolar depression.
CONCLUSION
Compared with the previous version, we found that more aggressive pharmacological strategies as an initial treatment were preferred, although various strategies were recommended as same as previous studies. Increased preference of AAP was prominent in KMAP-BP 2014. We expect this algorithm may be helpful in the treatment of bipolar disorder, depressive episode.
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