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양극성 장애의 한국형 약물치료 알고리듬Korean Medication Algorithm for Bipolar Disorder

Authors
박원명신영철전덕인윤보현김대진안용민권준수민경준
Issue Date
2002
Publisher
대한정신약물학회
Keywords
Bipolar disorder; Mania; Bipolar depression; Rapid cycling; Algorithm
Citation
대한정신약물학회지, v.13, no.3, pp 205 - 221
Pages
17
Journal Title
대한정신약물학회지
Volume
13
Number
3
Start Page
205
End Page
221
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/55045
ISSN
1017-5717
2092-5700
Abstract
Objective : Treating patients with bipolar disorder has many problems such as recurrent various episodes, breakthroughs, treatment resistance, switching and worsening of its course. In addition to these obstacles, recent developments of psychiatric medications make it difficult to choose the appropriate pharmacological options. This study was performed to survey the expert opinion of medication treatment for bipolar disorder. Methods : The survey questionnaire used in 'The Expert Consensus Guideline Series - Medication Treatment of Bipolar Disorder 2000' was translated in Korean and amended by executive committee according to Korean situations. Forty eight of 50(96%) members of review committee completed the survey. Results : In acute manic episode lithium or divalproex is a first-line drug as a monotherapy, and combination treatment is considered in partial or non-responder. Carbamazepine is also a first-line drug in dysphoric and mixed episodes. For moderate and more severe depression, an antidepressant is added with a mood stabilizer. For psychotic bipolar disorder, mania or depression, both atypical antipsychotics and high potency typical antipsychotics are preferred, but the latter is less likely to be recommended. A mood stabilizer should be used in rapid cycling bipolar illness. For manic episode in rapid cycler a mood stabilizer and an atypical antipsychotic drug are recommended in combination as an initial treatment. Conclusion : Most experts present strong consensus for many options concerning to initial strategies and first-line medications, although there are some non-consensus and gaps between research data and clinical usage in some steps. Nevertheless these data might be a cornerstone for producing the Korean medication algorithm for bipolar disorder.
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의과대학 (의학부(임상-서울))
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