한국형 양극성 장애 약물치료 알고리듬 2014: 우울 삽화

초록

Objective Since the Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was developed in 2002, thethird revision of KMAP-BP was performed in 2014 in order to reflect the recent rapid development and research of bipolardisorder and psychopharmacology. Methods According to methodology of previous versions, KMAP-BP 2014 was revised using the same questionnaire consistingof 14 questions. Sixty-four experts of the review committee completed the survey. The executive committee analyzed the results and discussed the final production of algorithm considering scientific evidence. Results The first-line pharmacotherapeutic strategy for acute bipolar depressive episode with moderate, non-psychotic severe and psychotic severe episode was mood stabilizer combined with atypical antipsychotic (AAP) or AAP with lamotrigine. Compared to KMAP-BP 2010, preference of AAP has been increased in the treatment of bipolar depressive episode in KMAPBP2014. Among AAPs, olanzapine, quetiapine and aripiprazole were preferred. When considering the efficacy and safety simultaneously,(es)citalopram, bupropion, and sertraline were recommended among antidepressants for bipolar depression. Conclusion Compared with the previous version, we found that more aggressive pharmacological strategies as an initial treatment were preferred, although various strategies were recommended as same as previous studies. Increased preferenceof AAP was prominent in KMAP-BP 2014. We expect this algorithm may be helpful in the treatment of bipolar disorder, depressive episode.

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