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KMID : 1009020230210010032
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Clinical Psychopharmacology and Neuroscience
2023 Volume.21 No. 1 p.32 ~ p.48
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Korean Medication Algorithm Project for Bipolar Disorder 2022: Comparisons with Other Treatment Guidelines
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Jeong Jong-Hyun
Bahk Won-Myong
Woo Young-Sup
Yoon Bo-Hyun
Lee Jung-Goo
Kim Won
Sohn In-Ki
Park Sung-Yong
Shim Se-Hoon
Seo Jeong-Seok
Choo Il-Han
Yang Chan-Mo
Jung Myung-Hun
Jon Duk-In
Kim Moon-Doo
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Abstract
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The objective of this study was to compare recommendations of the Korean Medication Algorithm Project for Bipolar Disorder 2022 (KMAP-BP 2022) with other recently published guidelines for treating bipolar disorder. We reviewed a total of six recently published global treatment guidelines and compared treatment recommendation of the KMAP-BP 2022 with those of other guidelines. For initial treatment of mania, there were no significant differences across treatment guidelines. All guidelines recommended mood stabilizer (MS) or atypical antipsychotic (AAP) monotherapy or a combination of an MS with an AAP as a first-line treatment strategy in a same degree for mania. However, the KMAP-BP 2022 recommended MS + AAP combination therapy for psychotic mania, mixed mania and psychotic depression as treatment of choice. Aripiprazole, quetiapine and olanzapine were the first-line AAPs for nearly all phases of bipolar disorder across guidelines. Some guideline suggested olanzapine is a second-line options during maintenance treatment, related to concern about long-term tolerability. Most guidelines advocated newer AAPs (asenapine, cariprazine, long-acting injectable risperidone, and aripiprazole once monthly) as first-line treatment options for all phases while lamotrigine was recommended for depressive and maintenance phases. Lithium and valproic acid were commonly used as MSs in all phases of bipolar disorder. KMAP-BP 2022 guidelines were similar to other guidelines, reflecting current changes in prescription patterns for bipolar disorder based on accumulated research data. Strong preference for combination therapy was characteristic of KMAP-BP 2022, predominantly in the treatment of psychotic mania, mixed mania and psychotic depression.
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KEYWORD
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Bipolar disorder, Pharmacotherapy, Algorithm, Guideline, KMAP-BP 2022
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