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KMID : 0941820230330030153
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Korean Journal of Clinical Pharmacy
2023 Volume.33 No. 3 p.153 ~ p.167
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Comparative Review of Pharmacological Treatment Guidelines for Bipolar Disorder
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Kim Ji-Young
Kim Hyo-Young
Kim Ye-Sul
Heo Chae-Won
Kwon Bo-Young
Choi Bo-Yoon
Lee Bo-Bae
Lee Ji-Ye
Kwon Chae-Eun
Mun Yeong-Do
Kaveesha Fernando
Park Ji-Hyun
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Abstract
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Objective : Bipolar disorder displays a spectrum of manifestations, including manic, hypomanic, depressive, mixed, psychotic, and atypical episodes, contributing to its chronic nature and association with heightened suicide risk. Creating effective pharmacotherapy guidelines is crucial for managing bipolar disorder and reducing its prevalence. Treatment algorithms grounded in science have improved symptom management, but variations in recommended medications arise from research differences, healthcare policies, and cultural nuances globally.
Methods : This study compares Korea’s bipolar disorder treatment algorithm with guidelines from the UK, Australia, and an international association. The aim is to uncover disparities in key recommended medications and their underlying factors. Differences in CYP450 genotypes affecting drug metabolism contribute to distinct recommended medications. Variances also stem from diverse guideline development approaches?expert consensus versus metaanalysis results?forming the primary differences between Korea and other countries.
Results : Discrepancies remain in international guidelines relying on meta-analyses due to timing and utilized studies. Drug approval speeds further impact medication selection. However, limited high-quality research results are the main cause of guideline variations, hampering consistent treatment conclusions.
Conclusion : Korea’s unique Delphi-based treatment algorithm stands out. To improve evidence-based recommendations, large-scale studies assessing bipolar disorder treatments for the Korean population are necessary. This foundation will ensure future recommendations are rooted in scientific evidence.
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KEYWORD
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Bipolar disorder, evidence-based practice, international comparisons, treatment of choice, treatment protocol
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