Korean J Psychopharmacol.
2006 Nov;17(6):528-537.
Korean Medication Algorithm for Bipolar Disorder 2006(V): Maintenance Therapy
- Affiliations
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- 1Naju National Hospital, Naju, Korea.
- 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea. wmbahk@catholic.ac.kr
- 3 Department of Psychiatry, Gwangju Veterans Hospital, Gwangju, Korea.
- 4Department of Psychiatry, College of Medicine, Chonbuk University, Jeonju, Korea.
- 5Department of Psychiatry and Stress Research Institute, College of Medicine, Inje University, Seoul, Korea.
- 6Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea.
- 7Department of Psychiatry, College of Medicine, Yonsei University, Seoul, Korea.
- 8Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Korea.
- 9Department of Psychiatry, College of Medicine, Konkuk University, Chungju, Korea.
- 10 Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea.
- 11Department of Psychiatry, Ilsan Hospital, National Health Insurance Corporation, Goyang, Korea.
- 12Department of Psychiatry, College of Medicine, Hallym University, Anyang, Korea.
- 13Korean College of Neuropsychopharmacology, Korean Society for Depressive and Bipolar Disorders, and Korean Academy of Schizophrenia, Seoul, Korea.
Abstract
OBJECTIVE
Since the previous publication of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) in 2002, there has been a substantial need for the revision of treatment algorithm due to rapid progress in the management for bipolar disorder. We focused on the maintenance treatment of bipolar I and bipolar II disorders of KMAP-BP revised in 2006. METHOD: The questionnaire to survey the expert opinion of medication for bipolar disorder was completed by the review committee consisting of 70 experienced psychiatrists. It was composed of 37 questions, and each question includes various sub-items. We classified the expert opinion to 3 categories (the first-line treatment, the second-line, the third-line) by x2 test. A part of this revision regarding maintenance treatment had 6 items ; 2 on bipolar I and 4 on bipolar II disorder.
RESULTS
There was no 'treatment of choice' in maintenance treatment. In case of bipolar I mania without history of depression, mood stabilizer (MS) monotherapy was 1st-line treatment. In maintenance management for bipolar II disorder, two treatment options were recommended. Treatment with MS alone or combinations of MS and atypical antipsychotics were preferred in recently recovered patients from hypomania. Atypical antipsychotics were more favored in the maintenance treatment for bipolar I and II disorders than previous KMAP-BP.
CONCLUSIONS
There is no 'treatment of choice' in maintenance strategies for bipolar disorder. Atypical antipsychotics are more preferred than the previous KMAP-BP. Also there is an increasing interest on the maintenance use of lamotrigine in bipolar depression.
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