J Korean Neuropsychiatr Assoc.  2022 Nov;61(4):274-280. 10.4306/jknpa.2022.61.4.274.

Korean Medication Algorithm Project for Bipolar Disorder 2022: Treatment Strategy According to Safety and Tolerability

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

Abstract


Objectives
The safety and tolerability of drugs are very important to ensure compliance and efficacy in the treatment of bipolar disorders. An expert opinion survey was conducted on treatment strategies in various special clinical situations, such as patients with significant weight gain, reporting characteristic drug side effects, low drug adherence, pregnant and reproductive women, and genetic counseling.
Methods
A written survey that addressed treatment strategies related to safety and tolerability was prepared. The survey focused on significant weight gain, characteristic drug side effects, low drug adherence, treatment of pregnant and reproductive women, and genetic counseling. Eighty-seven experts in the review committee completed the survey.
Results
In the case of weight gain occurring during drug treatment, it was considered preferable to replace the treatment drug with a drug that caused less weight gain, such as lamotrigine, aripiprazole, or ziprasidone. If there was a significant weight gain due to the treatment drug, it was considered preferable to intervene as soon as possible. In the case of hyperprolactinemia, it was considered preferable to change the drug. It was recommended that the drug beto discontinued in case of a benign rash as seen in patients treated with lamotrigine. For improving drug adherence, there was an increased preference for long-acting injections. It was also opined that antipsychotics should be used with great caution in pregnant or reproductive women.
Conclusion
Treatment strategies in various clinical situations related to the safety and tolerability of drugs for bipolar disorder have been described. It is hoped that this information would be useful in practical clinical situations.

Keyword

Bipolar disorder; Tolerability; Drug adherence; Reproductive women
Full Text Links
  • JKNA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr