한국형 양극성 장애 약물치표 알고리듬 2018 : 조증 삽화

Abstract

Objectives : We revised the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) 2014 to provide more timely information for the use of the information by clinicians. Methods : We performed the survey using a questionnaire for the treatment of manic or hypomanic episode in the participants. There were sixty-one members of the review committee who completed the survey. The executive committee analyzed the results and discussed the final production of the applicable algorithm as considering the scientific evidence. Results : The combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP) was recommended as the treatment of choice (TOC), and a monotherapy with an AAP was the first-line pharmacotherapeutic strategy for the initial treatment of mania, with or without psychotic features. The MS monotherapy was the first-line choice therapy, but only for the non-psychotic mania patients. When the initial treatment failed, the TOC was a combination of a MS and an AAP in mania with or without psychotic features, and a combination of two AAPs was TOC for the psychotic mania, as well. For hypomania, the monotherapy with MS or AAP was the first-line as initial treatment, and the recommended switch to or add an AAP was recommended when the initial strategies failed. Conclusion : Compared with the previous version, the experts recommend more intensive interventions earlier when initial treatment failed to respond to a recommended monotherapy.