Korean Medication Algorithm Project for Bipolar Disorder 2018 (KMAP-BP 2018): Fourth revision
Young Sup Woo 1, Won-Myong Bahk 1*, Jung Goo Lee 2, 3, Jong-Hyun Jeong 1, Moon-Doo Kim 4, InKi Sohn 5, Se-Hoon Shim 6, Duk-In Jon 7, Jeong Seok Seo 8, Kyung Joon Min 9, Won Kim 10, Hoo-Rim Song 11, Bo-Hyun Yoon 12
1Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea , 2Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University and Paik Institute for Clinical Research, Busan, Korea , 3Department of Health Science and Technology, Graduate School of Inje University, Busan, Korea, 4Department of Psychiatry, Jeju National University Hospital, Jeju, Korea, 5Department of Psychiatry, Keyo Hospital, Keyo Medical Foundation, Uiwang, Korea, 6Department of Psychiatry, Soonchunhyang University Cheonan Hospital, Soonchunhyang University, Cheonan, Korea, 7Department of Psychiatry, Sacred Heart Hospital, Hallym University, Anyang, Korea, 8Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea, 9Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea, 10Department of Psychiatry, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea, 11Department of Psychiatry, Myongji Hospital, Goyang, Korea, 12Department of Psychiatry, Naju National Hospital, Naju, Korea
Received: May 9, 2018; Revised: May 15, 2018; Accepted: May 15, 2018; Published online: May 15, 2018.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Abstract
Objective: The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP) was first published in 2002 through an expert consensus of opinion, and updated in 2006, 2010, and 2014. This study constitutes the fourth revision of the KMAP-BP.
Methods: A 50-item questionnaire was used to obtain the consensus of experts regarding pharmacological treatment strategies for various phases of adult bipolar disorder and six items for pediatric bipolar disorder. The review committee included 84 Korean psychiatrists and 43 child and adolescent psychiatry experts.
Results: The preferred first-step strategies for acute mania were the combination of a mood stabilizer (MS) and an atypical antipsychotic (AAP), MS monotherapy, and AAP monotherapy. A combination of a MS and an AAP, and AAP monotherapy were preferred for psychotic mania. The first-step strategies for mild to moderate bipolar depression were monotherapy with MS, AAP, or lamotrigine (LMT), and the combination of a MS and an AAP or LMT, or a combination of an AAP and LMT. The combination of two among a MS, AAP, and LMT were preferred for non-psychotic severe depression. A combination of a MS and an AAP or the combination of an AAP with an antidepressant or LMT were the first-line options for psychotic severe depression.
Conclusion: The recommendations of the KMAP-BP 2018 have changed from the previous version by reflecting recent developments in pharmacotherapy for bipolar disorder. KMAP-BP 2018 provides clinicians with a wealth of information regarding appropriate strategies for treating patients with bipolar disorder.
Keywords: Bipolar disorder, Expert consensus, Pharmacotherapy, Treatment guidelines


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