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한국형 양극성 장애 약물치료 알고리듬 2022: 급속 순환형

Korean Medication Algorithm Project for Bipolar Disorder 2022: Rapid Cycling

전덕인|정명훈|우영섭|추일한|박성용|서정석|김원|이정구|윤보현|김문두|심세훈|손인기|박원명|양찬모|정종현
대한신경정신의학회 (Korean Neuropsychiatric Association)|2022.08|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제61권 제3호|pp. 204-213|DOI https://doi.org/10.4306/jknpa.2022.61.3.204

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참고문헌

키워드

Bipolar disorderKMAP-BP 2022.Rapid cycling
주제분류정신과학

초록

Objectives This study revised the Korean Medication Algorithm Project for Bipolar Disorder2018 for rapid cycling. Methods Questionnaires to survey the expert opinion of medication for rapid cycling were completed by a review committee consisting of 87 Korean expert psychiatrists. The experts’ opinions ere classified into three categories based on the lowest category in which the confidence interval fell (6.5≤ for first-line, 3.5≤ for second-line, and 3.5> for third-line treatment). Results The first-line treatments were a combination of mood stabilizers and atypical antipsychotics, atypical antipsychotics monotherapy, or mood stabilizer monotherapy. Furthermore, amood stabilizer with lamotrigine therapy and an atypical antipsychotic with lamotrigine combinations was the first-line treatment for a depressive episode. The first-line medications in all episodeswere valproate, lithium, quetiapine, olanzapine, and aripiprazole. Risperidone was the first-linemedication in manic episodes and mixed states, and lamotrigine was the first-line medication fortreating depressive episodes. Conclusion Compared to the surveys in 2018, the preference for atypical antipsychotics andlamotrigine has increased, and the modalities as a second-line treatment are more diversified.

Abstract

Objectives This study revised the Korean Medication Algorithm Project for Bipolar Disorder2018 for rapid cycling. Methods Questionnaires to survey the expert opinion of medication for rapid cycling were completed by a review committee consisting of 87 Korean expert psychiatrists. The experts’ opinions ere classified into three categories based on the lowest category in which the confidence interval fell (6.5≤ for first-line, 3.5≤ for second-line, and 3.5> for third-line treatment). Results The first-line treatments were a combination of mood stabilizers and atypical antipsychotics, atypical antipsychotics monotherapy, or mood stabilizer monotherapy. Furthermore, amood stabilizer with lamotrigine therapy and an atypical antipsychotic with lamotrigine combinations was the first-line treatment for a depressive episode. The first-line medications in all episodeswere valproate, lithium, quetiapine, olanzapine, and aripiprazole. Risperidone was the first-linemedication in manic episodes and mixed states, and lamotrigine was the first-line medication fortreating depressive episodes. Conclusion Compared to the surveys in 2018, the preference for atypical antipsychotics andlamotrigine has increased, and the modalities as a second-line treatment are more diversified.

참고문헌 (40)

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