title: Revised Korean medication algorithm for bipolar disorder.
abstract: The rapid progress in treatments for bipolar disorder makes it necessary to revise the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) published in 2002. This study was performed to timely revise KMAP-BP 2002. A questionnaire comprising 37 questions and 645 treatment options was developed for surveying the opinions of Korean experts. We classified the opinions into three categories: first-, second-, and third-line treatments. Fifty-three (75.7%) of the 70 selected experts answered the questionnaire. For an acute manic episode, the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP) was the preferred first-line treatment. Most experts recommended divalproex and lithium as MSs, and olanzapine, quetiapine, and risperidone as AAPs. For moderately to severely depressed bipolar patients, MS monotherapy and a combination of an MS and an antidepressant (AD) were considered to be preferred treatments respectively. A combination of an MS and an AD was the preferred strategy in severe nonpsychotic depression. Most ADs were rated as second-line drugs. Overall, the preference for lamotrigine and AAPs was higher than in KMAP-BP 2002. The algorithm was developed mainly using consensus among experts supplemented with findings of recent clinical trials to ensure that our algorithm was both up to date and balanced. These results suggest that the medication strategies of KMAP-BP are changing rapidly, reflecting recent studies and clinical experiences.
authors.affiliation: Department of Psychiatry, Hallym University, Anyang, Korea.
authors.forename: Duk-In
authors.initials: DI
authors.lastname: Jon
authors.forename: Won-Myong
authors.initials: WM
authors.lastname: Bahk
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Yoon
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Shin
authors.forename: Hyun-Sang
authors.initials: HS
authors.lastname: Cho
authors.forename: Eun
authors.initials: E
authors.lastname: Lee
authors.forename: Kyooseob
authors.initials: K
authors.lastname: Ha
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Sang Keun
authors.initials: SK
authors.lastname: Chung
authors.forename: Jeong-Seok
authors.initials: JS
authors.lastname: Seo
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Min
mesh_terms: D000465:Algorithms; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D003987:Dibenzothiazepines / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D006282:Health Personnel; D006801:Humans; D007723:Korea / Q000453:epidemiology; D000077152:Olanzapine; D011570:Psychiatry / Q000706:statistics & numerical data; D000069348:Quetiapine Fumarate; D018967:Risperidone / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D001569:Benzodiazepines; D000069348:Quetiapine Fumarate; D014635:Valproic Acid; D018967:Risperidone; D000077152:Olanzapine