title: Korean medication algorithm for bipolar disorder: second revision.
abstract: BACKGROUND
  The Feasibility Study of the Korean Medication Algorithm Project for Bipolar Disorder 2002 (KMAP-BP 2002) revealed its clinical usefulness in 2005. Since much more data had become available since 2002, it was revised in 2006 as KMAP-BP 2006. For the same reason, revision of KMAP-BP 2006 is now necessary.
  
  
  METHODS
  The questionnaire, amended on the basis of KMAP-BP 2006 and new data, was sent to 94 experts, 65 of whom replied.
  
  
  RESULTS
  In an acute manic episode, a combination of a mood stabilizer (MS) with an atypical antipsychotic (AAP) is recommended as first-line strategy. Monotherapy with MS is first-line in a hypomanic episode. Triple combination of a MS, an AAP, and an antidepressant (AD), is the first-line strategy in non-psychotic severe depression. Also MS+AAP and MS+AD are recommended as first-line. In psychotic bipolar depression, MS+AAP+AD, MS+AAP and AAP+AD are first-line strategies. In bipolar depression, lithium, lamotrigine and valproic acid are selected as first-line MS and quetiapine, olanzapine and aripiprazole are preferred antipsychotics. In maintenance treatment, a combination of MS with AAP and monotherapy of MS are recommended as first-line.
  
  
  CONCLUSIONS
  In treating bipolar disorder, even the first step of treatment, the expert consensus has changed from our studies in 2002 and 2006.
authors.affiliation: Department of Psychiatry, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, Korea.
authors.forename: Young Chul
authors.initials: YC
authors.lastname: Shin
authors.forename: Kyung Joon
authors.initials: KJ
authors.lastname: Min
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Yoon
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Duk-In
authors.initials: DI
authors.lastname: Jon
authors.forename: Jeong-Seok
authors.initials: JS
authors.lastname: Seo
authors.forename: Young Sup
authors.initials: YS
authors.lastname: Woo
authors.forename: Jung Goo
authors.initials: JG
authors.lastname: Lee
authors.forename: Won-Myong
authors.initials: WM
authors.lastname: Bahk
mesh_terms: D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D018692:Antimanic Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy*; D032921:Consensus; D004359:Drug Therapy, Combination / Q000379:methods; D006801:Humans; D017410:Practice Guidelines as Topic; D011570:Psychiatry / Q000592:standards* / Q000639:trends; D056910:Republic of Korea; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents; D018692:Antimanic Agents; D014150:Antipsychotic Agents
keywords: algorithm; bipolar disorder; revision; treatment guideline