한국형 양극성 장애 약물치료 알고리듬：개정 및 향후 방향

Abstract

The algorithms and guidelines are a synthesis of current scientific evidences with clinical issues of safety and tolerability. It is inevitable that pharmacological strategies of psychiatric treatment have to be based on evidence-based medicine. The first Korean Medication Algorithm for Bipolar Disorder was developed from the information and opinions gathered by wide surveys to Korean psychiatrists and then, in the first time, its feasibility study was done. The problems on appropriateness of the shift of step, full education of algorithm administration and procedure before implementation, and easy applicability of measuring scales were found. These problems must be fully considered for algorithm implementation in the near future. Rapid updates on new evidences of therapeutic effects of drugs and recent trends of diagnostic concepts about bipolar disorder may justify revision of the medication algorithm. Especially, addition of widespread use of novel antipsychotics in all phases of illness, evidences of new anticonvulsants' effects, and change of strategies in the acute depression and maintenance treatments will have to be considered. Moreover, modification of questionnaire for algorithm revision will be needed in the aspect of easy implementation.