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KMID : 0361520080190010005
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Korean Journal of Psychopharmacology
2008 Volume.19 No. 1 p.5 ~ p.18
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Korean Medication Algorithm for Bipolar Disorder 2006(Ⅵ)：Comparisons with Other Treatment Guidelines
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Yoon Bo-Hyun
Bahk Won-Myong
Bae Seung-Oh
Jon Duk-In
Min Kyung-Jun
Shin Young-Chul
Cho Hyun-Sang
Chung Sang-Keun
Ha Kyoo-Seob
Seo Jeong-Seok
Kim Won
Lee Eun
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Abstract
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The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed in 2002 and revised in 2006. The aim of this study was to compare the KMAP-BP 2006 with other recently published treatment guidelines for bipolar disorder. We conducted a systematic review of the six most recently published guidelines and treatment algorithms for bipolar disorder to compare the similarities and differences between these guidelines and the KMAPBP 2006. Most treatment guidelines had similarities in their treatment options. The guidelines generally advocated atypical antipsychotics as first-line treatment in the manic phase and lamotrigine in the depressive phase. While lithium and divalproex were commonly used as mood stabilizers in the manic phase, divalproex was recommended in mixed or dysphoric mania. Mood stabilizers or atypical antipsychotics were selected as first-line treatment in maintenance. Some guidelines were more concerned about special clinical situations such as pregnancy, obesity, metabolic syndrome, and elderly patients, which were not described in the KMAP-BP 2006. Our findings suggest that the medication strategies for bipolar disorder are based on data from recent studies and clinical experiences. Useful information and a rationale for making sequential treatment decisions can be provided by critically reviewing the treatment guidelines. The treatment algorithms and guidelines are not substitutes for clinical judgment, but can serve as critical references to complement individual clinical assessments.
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KEYWORD
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Bipolar disorder, Pharmacotherapy, Treatment guideline, Algorithm
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