한국형 양극성 장애 약물치료 알고리듬 2010 : 유지치료

Abstract

Objective : After announcement of Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) in 2006, there has been an increasing need for the revision of treatment algorithm due to rapid changes in the management for bipolar disorder. In this study, we evaluated the maintenance treatment of bipolar I and bipolar II disorders of KMAP-BP 2010. Method : The questionnaire to survey the expert opinion of medication for bipolar disorder was completed by the review committee consisting of 65 experienced psychiatrists. It is composed of 37 questions, and each question includes various sub-items. We classified the expert opinion to 3 categories (the first-line treatment, the second-line, the third-line) by χ2 test. A part of this revision regarding maintenance treatment had 7 items ; 5 on bipolar I and 2 on bipolar II disorder. Results : In case of bipolar I disorder, mood stabilizer monotherapy and combination of mood stabilizer and atypical antipsychotic drugs were 1st-line treatment. In maintenance management for bipolar II disorder, two treatment options were recommended. Treatment with MS alone or combinations of MS and atypical antipsychotic drugs were preferred. Atypical antipsychotic drugs and lamotrigine were more favored in the maintenance treatment for bipolar I and II disorders than previous KAMP-BP 2006. Conclusions : There have been growing body of tendency that atypical antipsychotics are more preferred than the previous KMAP-BP. Also there is an increasing interest on the maintenance use of lamotrigine in the maintenance treatment of bipolar disorder.