한국형 양극성 장애 약물치료 알고리듬 2026: 우울 삽화

초록

Objectives Since the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first developed in 2002, the sixth revision was undertaken in 2026 to reflect the recent advances in research and treatment approaches for bipolar disorder. This study developed expert consensus recommendations for managing acute depressive episodes of bipolar disorder, as part of KMAP-BP 2026. Methods KMAP-BP 2026 involved a nationwide expert survey of 90 psychiatrists, of whom 67 responded (response rate: 74.4%). The questionnaire was based on previous editions and revised to incorporate recent clinical developments. The recommendations were categorized as first-, second-, or third-line options based on 95% confidence interval thresholds and chi-square analyses. Results Compared with KMAP-BP 2022, KMAP-BP 2026 showed an increased preference for monotherapy with atypical antipsychotics for the treatment of acute bipolar depressive episode, including aripiprazole, quetiapine, olanzapine, and lurasidone. Regarding mood stabilizers, the preference for lithium and lamotrigine remained unchanged, whereas the preference for valproate decreased. Conclusion KMAP-BP 2026 maintains the core treatment recommendations for acute bipolar depression. Pharmacotherapy for acute depressive episodes continues to show greater diversity across clinical presentations and subtypes compared with mania. These updated guidelines underscore the importance of personalized treatment strategies in the management of bipolar depression.

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