한국형 양극성 장애 약물치료 알고리듬 2022: 안전성과 내약성을 고려한 치료전략

초록

Objectives The safety and tolerability of drugs are very important to ensure compliance and ef ficacy in the treatment of bipolar disorders. An expert opinion survey was conducted on treat ment strategies in various special clinical situations, such as patients with significant weight gain, reporting characteristic drug side effects, low drug adherence, pregnant and reproductive wom en, and genetic counseling. Methods A written survey that addressed treatment strategies related to safety and tolerability was prepared. The survey focused on significant weight gain, characteristic drug side effects, low drug adherence, treatment of pregnant and reproductive women, and genetic counseling. Eighty-seven experts in the review committee completed the survey Results In the case of weight gain occurring during drug treatment, it was considered preferable to replace the treatment drug with a drug that caused less weight gain, such as lamotrigine, aripip razole, or ziprasidone. If there was a significant weight gain due to the treatment drug, it was con sidered preferable to intervene as soon as possible. In the case of hyperprolactinemia, it was con sidered preferable to change the drug. It was recommended that the drug beto discontinued in case of a benign rash as seen in patients treated with lamotrigine. For improving drug adherence, there was an increased preference for long-acting injections. It was also opined that antipsychot ics should be used with great caution in pregnant or reproductive women. Conclusion Treatment strategies in various clinical situations related to the safety and tolerability of drugs for bipolar disorder have been described. It is hoped that this information would be use ful in practical clinical situations.

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