Korean Medication Algorithm for Bipolar Disorder 2014: Manic Episode.
- Author:
Young Sup WOO
1
;
Won Myong BAHK
;
Duk In JON
;
Jeong Seok SEO
;
Jung Goo LEE
;
Jong Hyun JEONG
;
Moon Doo KIM
;
Inki SOHN
;
Se Hoon SHIM
;
Kyung Joon MIN
;
Bo Hyun YOON
;
Young Chul SHIN
Author Information
1. Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. wmbahk@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Bipolar disorder;
Manic episode;
Pharmacotherapy;
Algorithm
- MeSH:
Advisory Committees;
Anticonvulsants;
Antipsychotic Agents;
Bipolar Disorder*;
Drug Therapy;
Humans;
Lithium;
Psychopharmacology;
Surveys and Questionnaires;
Recurrence;
Valproic Acid;
Aripiprazole;
Quetiapine Fumarate
- From:Korean Journal of Psychopharmacology
2014;25(2):57-67
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The pharmacotherapy of bipolar disorder has many difficulties such as various clinical feature according to each episode, recurrence, breakthroughs, treatment resistance, switching and worsening of its course. Recent rapid development and research of bipolar disorder and psychopharmacology, including atypical antipsychotics and new anticonvulsants, make it more difficult to choose the appropriate pharmacological options. Therefore, we decided to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2010 in order to provide more proper guideline for clinicians. METHODS: Like the previous version, KMAP-BP 2010, we performed the survey using questionnaire comprising 55 main questions in which 8 main questions and 478 sub-items for treatment of manic or hypomanic episode were included. Sixty-four members 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 manic episode is combination of mood stabilizer and an atypical antipsychotic, and it is the treatment of choice for euphoric, psychotic and dysphoric/mixed mania. The preference for monotherapy with atypical antipsychotic (for all three types of mania) or mood stabilizer (for euphoric mania) was increased in KMAP-BP 2014. Valproic acid and lithium are chosen as the preferred mood stabilizer of the first-line treatment of acute manic episode and valproic acid was the treatment of choice for all types of mania. Atypical antipsychotics is more widely accepted than before in manic and hypomanic episode. Moreover, the preference for combination treatment in manic patients who failed to respond in early stage treatment was increased. CONCLUSION: Compared with the previous version, we found that 'no-consensus' decreases in this revision. These suggest that the many clinicians agree with others in the treatment of acute manic/hypomanic episode, and the pharmacotherapy of manic/hypomanic episode become more obvious than before. Atypical antipsychotics such as aripiprazole, olanzapine and quetiapine gain more awareness in the treatment of bipolar mania and hypomania. We expect this algorithm may provide clinicians good information and help about the treatment of bipolar disorder, manic/hypomanic episode.
