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KMID : 0361520140250040161
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Korean Journal of Psychopharmacology
2014 Volume.25 No. 4 p.161 ~ p.167
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Korean Medication Algorithm for Bipolar Disorder 2014: Safety and Tolerability
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Sohn In-Ki
Kim Moon-Doo
Lee Jung-Goo
Yoon Bo-Hyun
Jeong Jong-Hyun
Shim Se-Hoon
Woo Young-Sup
Seo Jeong-Seok
Shin Young-Chul
Min Kyung-Joon
Bahk Won-Myong
Jon Duk-In
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Abstract
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Objective: The complexity of the treatment for bipolar disorder is often caused by the presence of side effects of various psychiatric medications. In particular, weight gain and metabolic syndrome are currently major concerns in the medication for bipolar disorders. Therefore, we undertook a survey of expert opinion to help make clinical decisions in these special situations.
Methods A written survey which asked about treatment strategies in the safety and tolerability was prepared; 1) weight gain, 2) antipsychotic related hyperprolactinemia, 3) lamotrigine related skin rash, 4) treatment non-adherence, and 5) genetic counselling. Treatment options were scored using a 9-point scale for rating appropriateness of clinical decisions in some issues. In other issues, experts were asked to choose to determine the ranking of preferences on the list. Sixty-four experts of the review committee completed the survey. We classified the expert opinions about preferences by chi2 test.
Results: Experts preferred behavioral and diet modification for weight gain, switching to prolactin-sparing-antipsychotics for antipsychotic-induced hyperprolactinemia, reducing dose of lamotrigene for its related benign skin rash, and prescribing once a day for treatment adherence.
Conclusion: With the limitation of expert opinion, authors hope that the results of this study provide valuable information to make clinical decision about the treatment of bipolar disorder in the complicated situations.
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KEYWORD
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Bipolar disorder, Weight gain, Non-adherence, Lamotrigine, Hyperprolactinemia, Genetic counselling, Algorithm
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