J Korean Neuropsychiatr Assoc.  2022 Aug;61(3):214-223. 10.4306/jknpa.2022.61.3.214.

Korean Medication Algorithm Project for Bipolar Disorder 2022: Maintenance Therapy

Affiliations
  • 1Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Korea
  • 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
  • 3Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
  • 4Department of Psychiatry, Chosun University Hospital, College of Medicine, Chosun University, Gwangju, Korea
  • 5Department of Psychiatry, Wonkwang University Hospital, Wonkwang University School of Medicine, Iksan, Korea
  • 6Department of Psychiatry, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
  • 7Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
  • 8Department of Psychiatry, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
  • 9Department of Psychiatry, Keyo Hospital, Uiwang, Korea
  • 10Department of Psychiatry, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
  • 11Department of Psychiatry, Naju National Hospital, Naju, Korea

Abstract


Objectives
In this study, we investigated and organized the maintenance-treatment strategies for Bipolar I and II disorders outlined in The Korean Medication Algorithm Project for Bipolar disorder 2022 (KMAP-BP 2022).
Methods
The questionnaire sought to survey expert opinion on medication for bipolar disorders and was completed by a review committee consisting of 87 experienced Korean psychiatrists. It comprised 56 questions, and each question included various sub-items. The questionnaire for the maintenance treatments covered overall treatment strategies after acute mood episodes in bipolar I and II disorders, the choice of mood stabilizers and atypical antipsychotics and antidepressants, duration of medication, and treatment strategies for breakthrough symptoms.
Results
In the case of bipolar I disorder, mood stabilizer monotherapy, atypical antipsychotics monotherapy, and a combination of mood stabilizers and atypical antipsychotics were selected as the first-line treatments. In maintenance management of bipolar II disorder, mood stabilizer monotherapy, atypical antipsychotics monotherapy, and combinations of mood stabilizers were selected as the preferred first-line treatments.
Conclusion
There has been a growing body of evidence that atypical antipsychotics have a greater preference than observed in the previous KMAP-BP of 2018. Also, monotherapy of mood stabilizers or atypical antipsychotics was more frequently selected in KMAP-BP 2022 than in the KMAP-BP 2018.

Keyword

Bipolar disorder; KMAP-BP 2022; Maintenance therapy
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