Our goal was to compare the recommendations of the Korean Medication Algorithm Project for
Bipolar Disorder 2014 (KMAP-BP 2014) with other recently published guidelines for the treatment of
bipolar disorder. We reviewed a total of four recently published global treatment guidelines and compared each treatment recommendation of the KMAP-BP 2014 with those in other guidelines. For the initial treatment of
mania, there were no significant differences across treatment guidelines. All recommended mood stabilizer (MS) or atypical
antipsychotic (
AAP) monotherapy or the combination of an MS with an
AAP as a first-line treatment strategy for
mania. However, the KMAP-BP 2014 did not prefer monotherapy with MS or
AAP for dysphoric/psychotic
mania.
Aripiprazole,
olanzapine,
quetiapine, and
risperidone were the first-line AAPs in nearly all of the phases of
bipolar disorder across the guidelines. Most guidelines advocated newer AAPs as first-line treatment options in all phases, and
lamotrigine in depressive and maintenance phases.
Lithium and
valproic acid were commonly used as MSs in all phases of
bipolar disorder. As research evidence accumulated over time, recommendations of newer AAPs - such as
asenapine,
paliperidone,
lurasidone, and long-acting
injectable risperidone - became prominent. This comparison identifies that the treatment recommendations of the KMAP-BP 2014 are similar to those of other treatment guidelines and reflect current changes in prescription patterns for
bipolar disorder based on accumulated research data. Further studies are needed to address several issues identified in our review.