양극성 장애의 한국형 약물치료 알고리듬(V)：다른 치료 지침들과의 비교

Abstract

Objectives: The Korean Medication Algorithm for Bipolar Disorder (KMAP-BP) was developed in 2002 and subsequent minor revisions for mania, bipolar depression and rapid cycling were published recently. To compare the similarity and discrepancy, the authors who engaged in developing KMAP-BP as the executive members reviewed treatment guidelines for bipolar disorder. Methods: The authors fully reviewed 6 currently available treatment guidelines and many literatures on the described points of overlap and discordance among guidelines and then compared along with various phases of bipolar disorder. Results: KMAP-BP was structurally similar to Expert Consensus Guideline Series for Bipolar Disorder. In aspects of treatment options, most of all treatment guidelines were similar, but KMAP-BP advocated the antipsychotics as early treatment options and had fewer consensus on the preferences among mood stabilizers. Also, KMAP-BP was not concerned about the special clinical situations such as pregnancy, adolescence and elderly patients and lacked the general descriptions of psychotrophics commonly used as mood stabilizers. Conclusion: This review suggests that consultation of treatment guidelines may provide clinicians with useful information and a rationale for making sequential treatment decisions. It also consistently stressed that treatment algorithm or guidelines are not a substitute for clinical judgment; they may serve as a critical reference to complement individual clinical judgment