Algorithm-driven treatment for bipolar disorder in Korea: Clinical feasibility, efficacy, and safety

Objective. The Korean Medication Algorithm Project for Bipolar Disorder (KMAP-BP 2002) was developed in 2002. The aim of this study was to evaluate the clinical feasibility, efficacy, and safety of implementation of the KMAP-BP 2002 algorithm in clinical situations. Methods. Participating investigators were asked to follow the KMAP-BP 2002 algorithm as much as possible, but they were allowed to change their treatment strategies as they considered necessary. The enrolled patients were followed for 4 months. Results. A total of 126 bipolar patients were consecutively enrolled and 73% were treated according to the KAMP-BP 2002 algorithm. The majority (79%) of manic patients demonstrated a treatment response at the starting step and were thus treated with only one step of the algorithm. An atypical antipsychotic drug was coadministered with a mood stabilizer from the beginning of treatment in almost all manic patients. There was a significant improvement in manic symptoms (F=187.32, P<0.001) over the 4-month testing period. There was no significant increase in side effects at the endpoint. Overall, the investigators were satisfied with implementing the algorithm. Conclusion. These results suggest that the KMAP-BP 2002 algorithm could be implemented effectively and safely in clinical practice.