Conflict of interest: None.
Korean medication algorithm for bipolar disorder: Second revision
Version of Record online: 1 APR 2013
Copyright © 2013 Wiley Publishing Asia Pty Ltd
Volume 5, Issue 4, pages 301–308, December 2013
How to Cite
Shin, Y. C., Min, K. J., Yoon, B.-H., Kim, W., Jon, D.-I., Seo, J.-S., Woo, Y. S., Lee, J. G. and Bahk, W.-M. (2013), Korean medication algorithm for bipolar disorder: Second revision. Asia-Pacific Psychiatry, 5: 301–308. doi: 10.1111/appy.12062
- Issue online: 30 OCT 2013
- Version of Record online: 1 APR 2013
- Manuscript Accepted: 13 JAN 2013
- Manuscript Received: 4 NOV 2012
- bipolar disorder;
- treatment guideline
The Feasibility Study of the Korean Medication Algorithm Project for Bipolar Disorder 2002 (KMAP-BP 2002) revealed its clinical usefulness in 2005. Since much more data had become available since 2002, it was revised in 2006 as KMAP-BP 2006. For the same reason, revision of KMAP-BP 2006 is now necessary.
The questionnaire, amended on the basis of KMAP-BP 2006 and new data, was sent to 94 experts, 65 of whom replied.
In an acute manic episode, a combination of a mood stabilizer (MS) with an atypical antipsychotic (AAP) is recommended as first-line strategy. Monotherapy with MS is first-line in a hypomanic episode. Triple combination of a MS, an AAP, and an antidepressant (AD), is the first-line strategy in non-psychotic severe depression. Also MS+AAP and MS+AD are recommended as first-line. In psychotic bipolar depression, MS+AAP+AD, MS+AAP and AAP+AD are first-line strategies. In bipolar depression, lithium, lamotrigine and valproic acid are selected as first-line MS and quetiapine, olanzapine and aripiprazole are preferred antipsychotics. In maintenance treatment, a combination of MS with AAP and monotherapy of MS are recommended as first-line.
In treating bipolar disorder, even the first step of treatment, the expert consensus has changed from our studies in 2002 and 2006.