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KMID : 0361520060170060528
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Korean Journal of Psychopharmacology
2006 Volume.17 No. 6 p.528 ~ p.537
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Korean Medication Algorithm for Bipolar Disorder 2006(V)：Maintenance Therapy
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Yoon Bo-Hyun
Bahk Won-Myong
Bae Seung-Oh
Chung Sang-Keun
Kim Won
Shin Young-Chul
Cho Hyun-Sang
kwon Jun-Soo
Seo Jeong-Seok
Ha Kyoo-Seob
Min Kyung-Jun
Lee Eun
Jon Duk-In
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Abstract
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Objective： Since the previous publication of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) in 2002, there has been a substantial need for the revision of treatment algorithm due to rapid progress in the management for bipolar disorder. We focused on the maintenance treatment of bipolar I and bipolar II disorders of KMAP-BP revised in 2006.
Method： The questionnaire to survey the expert opinion of medication for bipolar disorder was completed by the review committee consisting of 70 experienced psychiatrists. It was composed of 37 questions, and each question includes various sub-items. We classified the expert opinion to 3 categories (the first-line treatment, the second-line, the third-line) by χ² test. A part of this revision regarding maintenance treatment had 6 items；2 on bipolar I and 4 on bipolar II disorder.
Results： There was no ‘treatment of choice’ in maintenance treatment. In case of bipolar I mania without history of depression, mood stabilizer (MS) monotherapy was 1st-line treatment. In maintenance management for bipolar II disorder, two treatment options were recommended. Treatment with MS alone or combinations of MS and atypical antipsychotics were preferred in recently recovered patients from hypomania. Atypical antipsychotics were more favored in the maintenance treatment for bipolar I and II disorders than previous KMAP-BP.
Conclusions： There is no ‘treatment of choice’ in maintenance strategies for bipolar disorder. Atypical antipsychotics are more preferred than the previous KMAP-BP. Also there is an increasing interest on the maintenance use of lamotrigine in bipolar depression.
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KEYWORD
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Bipolar disorder, Maintenance, Pharmacotherapy, Algorithm
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