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KMID : 0361520060170050449
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Korean Journal of Psychopharmacology
2006 Volume.17 No. 5 p.449 ~ p.455
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Korean Medication Algorithm for Bipolar Disorder 2006(Ⅳ) : Rapid Cycling
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전덕인/Jon DI
박원명/이은/윤보현/정상근/김원/신영철/조현상/권준수/서정석/하규섭/민경준/Bahk WM/Lee E/Yoon BH/Chung SK/Kim W/Shin YC/Cho HS/Kwon JS/Seo JS/Ha KS/Min KJ
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Abstract
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Objective : The development of treatment guidelines has emerged as an important element so as to standardize treatment and to provide clinicians with algorithms. From the previous publication of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP): rapid cycling in 2002, we revised that in 2006.
Methods : The questionnaire to survey the expert opinion of medication for rapid cycling was completed by the review committee consisting of 53 experienced Korean psychiatrists. It is composed of 7 questions, and each question includes various options. We classified the expert opinion to 3 categories based on the lowest category in which the confidence interval fell (6.5≤for first-line and 3.5≤for second-line treatment).
Results : Generally, ‘treatment of choice’ for rapid cycling was not demonstrated. The first-line treatment is the combination of a mood stabilizer and an atypical antipsychotic. Combination of two mood stabilizers was preferred as next strategy. Divalproex and lithium were the first-line choice as mood stabilizer. Compared to the surveys in 2002, the preference for lamotrigine and atypical antipsychotics has increased while that of carbamazepine and antidepressant has decreased.
Conclusion : With the result of the survey, the discussion in executive committee, and the evidences from clinical studies, we have revised KMAP-BP for rapid cycling.
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KEYWORD
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