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KMID : 0361520140250020068
Korean Journal of Psychopharmacology
2014 Volume.25 No. 2 p.68 ~ p.78
Korean Medication Algorithm for Bipolar Disorder 2014: Depressive Episode
Seo Jeong-Seok

Bahk Won-Myong
Lee Jung-Goo
Woo Young-Sup
Jeong Jong-Hyun
Wang Hee-Ryung
Kim Moon-Doo
Sohn In-Ki
Shim Se-Hoon
Min Kyung-Jun
Jon Duk-In
Shin Young-Chul
Yoon Bo-Hyun
Abstract
Objective: Since the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed in 2002, the third revision of KMAP-BP was performed in 2014 in order to reflect the recent rapid development and research of bipolar disorder and psychopharmacology.

Methods: According to methodology of previous versions, KMAP-BP 2014 was revised using the same questionnaire consisting of 14 questions. Sixty-four experts of the review committee completed the survey. The executive committee analyzed the results and discussed the final production of algorithm considering scientific evidence.

Results: The first-line pharmacotherapeutic strategy for acute bipolar depressive episode with moderate, non-psychotic severe and psychotic severe episode was mood stabilizer combined with atypical antipsychotic (AAP) or AAP with lamotrigine. Compared to KMAP-BP 2010, preference of AAP has been increased in the treatment of bipolar depressive episode in KMAPBP 2014. Among AAPs, olanzapine, quetiapine and aripiprazole were preferred. When considering the efficacy and safety simultaneously, (es)citalopram, bupropion, and sertraline were recommended among antidepressants for bipolar depression.

Conclusion: Compared with the previous version, we found that more aggressive pharmacological strategies as an initial treatment were preferred, although various strategies were recommended as same as previous studies. Increased preference of AAP was prominent in KMAP-BP 2014. We expect this algorithm may be helpful in the treatment of bipolar disorder, depressive episode.
KEYWORD
Bipolar disorder, Depressive episode, Pharmacotherapy, Algorithm
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