Korean Medication Algorithm for Bipolar Disorder 2006(VI): Comparisons with Other Treatment Guidelines

Korean Medication Algorithm for Bipolar Disorder(V): Comparisons with Other Treatment Guidelines Bo-Hyun Yoon, MD, Duk-In Jon, MD, Young-Chul Shin, MD, Kyung-Joon Min, MD, Jun-Soo Kwon, MD and Won-Myong Bahk, MD Naju National Hospital, Naju, Department of Psychiatry, Ilsan Hospital, National Health Insurance Corporation, Goyang, Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University, Seoul, Department of Neuropsychiatry, College of Medicine, Chung-Ang University, Seoul, Department of Psychiatry, Seoul National University College of Medicine, Seoul, Department of Psychiatry, College of Medicine, Catholic University, Seoul, Korea Objective: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 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. (Korean J Psychopharmacol 2004;15(2):162-174)