Clin Psychopharmacol Neurosci.  2022 Nov;20(4):747-761. 10.9758/cpn.2022.20.4.747.

Korean Medication Algorithm Project for Bipolar Disorder 2022, Fifth Revision: An Executive Summary

Affiliations
  • 1Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 2Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
  • 3Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
  • 4Department of Psychiatry, Keyo Hospital, Uiwang, Korea
  • 5Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
  • 6Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
  • 7Department of Psychiatry, College of Medicine, Chosun University, Gwangju, Korea
  • 8Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
  • 9Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
  • 10Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
  • 11Department of Psychiatry, Naju National Hospital, Naju, Korea

Abstract


Objective
We revised the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP), first published in 2002 and revised in 2006, 2010, 2014, and 2018, to reflect recent progress in the treatment of bipolar disorder.
Methods
The questionnaires consisted of 56 items for adult patients and 7 items for child/adolescent patients, and were used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of bipolar disorder. The review committee included 87 Korean psychiatrists and 40 child and adolescent psychiatry experts.
Results
For treatment of manic episodes, a combination of a mood stabilizer (MS) and atypical antipsychotics (AAP), or monotherapy with MS or AAP were recommended as first-line treatments. Combinations of MS and AAP, or AAP and lamotrigine (LMT) were recommended as first-line treatments for depressive episodes regardless of the severity. Monotherapy with MS, AAP, or LMT were also first-line treatments for mild to moderate depressive episodes. For mixed features, a combination of MS and AAP, or monotherapy with AAP or MS were recommended as first-line treatments, and a combination of AAP and LMT, or MS and LMT were the first-line treatments for depressive mixed state.
Conclusion
The recommendations of the KMAP-BP 2022 have changed from the previous version, to reflect the evolution of the social culture and healthcare system in Korea and recent evidence regarding pharmacotherapy of bipolar disorder. The KMAP-BP 2022 provides clinicians with a wealth of information regarding appropriate strategies to treat patients with bipolar disorder.

Keyword

Bipolar disorder; KMAP-BP 2022; Expert consensus; Pharmacotherapy
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