한국형 양극성장애 약물치료 알고리듬 2014 : 급속순환

초록

Objectives : Bipolar disorder is an illness with significant morbidity and mortality that contributes to disturb social function. Our objective for this study is to revise Korean Medication Algorithm Project for Bipolar Disorder 2010 for rapid cycling. Methods : The questionnaires to survey the expert opinion of medication for rapid cycling were completed by the review committee consisting of 64 Korean expert psychiatrists. We classified the experts’ opinion to 3 categories based on the lowest category in which the confidence interval fall (6.5≤ for first-line and 3.5≤ for second-line treatment). Results : The first-line treatment was the combination of a mood stabilizer and an atypical antipsychotic. And also, monotherapy of atypical antipsychotics was included in the first-line treatment. Additionally, a mood stabilizer with lamotirgine therapy and an atypical antipsychotic with lamotrigine combinations were the first-line treatment in depressive phase. Mood stabilizer monotherapy, combination of two mood stabilizers, combination of mood stabilizer, atypical antipsychotics and antidepressants were preferred as next strategy. The first-line medications in all cases are valproic acid, lithium, quetiapine, olanzapine and aripiprazole. For the treatment of depressive phase, lamotrigine is the first-line medication. Conclusion : Compared to the surveys in 2010, the preference for atypical antipsychotics and lamotrigine were increased, and modalities as a second-line treatment were diverse

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