Korean Medication Algorithm Project for Bipolar Disorder 2022:Mixed Features
10.4306/jknpa.2022.61.2.133
- Author:
Won KIM
1
;
Won-Myong BAHK
;
Young Sup WOO
;
Jong-Hyun JEONG
;
Jeong Seok SEO
;
IL Han CHOO
;
Chan-Mo YANG
;
Jung Goo LEE
;
Se-Hoon SHIM
;
Bo-Hyun YOON
;
Sung-Yong PARK
;
InKi SOHN
;
Moon-Doo KIM
;
Myung Hun JUNG
;
Duk-In JON
Author Information
1. Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Korean Neuropsychiatric Association
2022;61(2):133-142
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:Treatment guidelines or an algorithm can help clinicians implement better practices and clinical decisions. Therefore, the Korean Medication Algorithm Project for Bipolar Disorder 2022 (KMAP-BP 2022) was revised again through a consensus of expert opinion. The diagnosis and treatment of mixed features are not simple, and there are many things to discuss. We describe the preferences and recommendations from KMAP-BP 2022 for the treatment of mood episodes with mixed features.
Methods:We revised the KMAP-BP 2018 questionnaire and conducted the survey with expert clinicians. Out of ninety-three members of the review committee, eighty-seven completed the survey. We analyzed the answers, discussed the data, and held a clinician hearing.
Results:In first-step strategies for mixed features with more manic symptoms, a combination of a mood stabilizer and an atypical antipsychotic is the treatment of choice. Mood stabilizer monotherapy and atypical antipsychotic monotherapy are preferred strategies. For mixed features with more depressive symptoms, a combination of mood stabilizer and atypical antipsychotic, a combination of atypical antipsychotic and lamotrigine (LMT), atypical antipsychotic monotherapy, a combination of mood stabilizer and LMT, and mood stabilizer monotherapy are preferred. For mixed features with similar manic symptoms and depressive symptoms, a combination of mood stabilizer and atypical antipsychotic, atypical antipsychotic monotherapy, and mood stabilizer monotherapy are preferred.
Conclusion:For mixed features, a combination of mood stabilizer and atypical antipsychotic is generally preferred, and LMT is preferred for depressive symptoms. Compared with KMAP-BP 2018, more diverse strategies and drugs are being attempted for the treatment of mixed features.
