pISSN 1226-6051
eISSN 2508-786X
eISSN 2508-786X
Treatment for acute mania across practice guidelines
| Guidelines | First-line treatment | Next-step intervention | Later intervention |
|---|---|---|---|
| KMAP-BP 2022 | · Euphoric: ARI, Li, OLA, QUE, Val, MS + AAP (ARI/OLA/QUE/RIS) · Psychotic: ARI, OLA, QUE, RIS, MS + AAP (OLA/QUE/ARI/RIS) · Hypomania: ARI, Li, QUE, Val, MS + AAP (ARI/QUE) |
· Euphoric: adding or replace MS or AAP, MS + AAP, 2MSs · Psychotic: adding or replace MS or AAP, MS + AAP, 2AAPs, 2MSs + AAP · Hypomania: adding or replace MS or AAP (OLA, RIS), MS + AAP |
· Euphoric: 2MSs + AAP, MS + 2AAPs, 2MSs + 2AAPs, CLZ, ECT · Psychotic: MS + 2AAPs, 2MSs + 2AAPs, CLZ, ECT · Hypomania: 2MSs, 2AAPs, 2MSs + AAP, MS + 2AAPs, TAP |
| BAP 2016 | · Without AM: HAL, OLA, RIS, QUE, Val · With AM: optimization, Add HAL, OLA, RIS, QUE, another MS |
· Without AM: alternative AM (ARI, other AP, CBZ, LIT) · With AM: MS + AAP |
|
| CANMAT 2018 | Li, QUE, Val, ASP, ARI, PAL, RIS, CAR Combination with MS: QUE, ARI, RIS, ASP |
OLA, CBZ, OLA + Li (or Val), Li + Val, ZIP, HAL, ECT | CBZ + Li (or Val), CPZ, CNZP, CLZ, HAL + Li (or Val), rTMS, tamoxifen, tamoxifen + Li (or Val) |
| CINP-BD-2017 | ARI, ASP, CAR, PAL, QUE, RIS, Val, Switch to other first-step monotherapy | OLA, Li, CBZ, HAL, Li (or Val) + ARI (or HAL or OLA or QUE or RIS), Li + allopurinol, Val + TAP, MS + medroxyprogesterone, Val + celcoxib Alternative AP or adding Li or Val | ECT, OXC |
| NICE 2014 | · Without AM: HAL, OLA, QUE, RIS · With AM: optimization, adding HAL, OLA, QUE, RIS |
Alternative AP or adding Li or Val | ECT |
| RANZCP 2020 | ARI, ASP, RIS, QUE, CAR, Li, Val, MS + AAP | CBZ, ZIP, HAL, OLA | ECT |
AP, antipsychotic; AAP, atypical antipsychotic; ASP, asenapine; AM, anti-manic agents; ARI, aripiprazole; BAP 2016, The British Association for Psychopharmacology Guidelines for Treatment for Bipolar Disorder 2016; CANMAT 2018, Canadian Network for Mood and Anxiety Treatments 2018; CAR, cariprazine; CBZ, carbamazepine; CINP-BD 2017, The International College of Neuropsychopharmacology Treatment Guidelines for Bipolar Disorder 2017; CLZ, clozapine; CNZP, clonazepam; CPZ, chlorpromazine; ECT, electroconvulsive therapy; HAL, haloperidol; KMAP-BP 2022, Korean Medication Algorithms for Bipolar Disorder 2022; Li, lithium; MS, mood stabilizer; NICE 2014, National Institute for Health and Clinical Excellence Treatment for Bipolar Disorder 2014; OLA, olanzapine; OXC, oxcarbazepine. PAL, paliperidone; QUE, quetiapine; RANZCP 2020, The 2020 Royal Australian and New Zealand College of psychiatrists clinical practice guidelines for mood disorders; RIS, risperidone; rTMS, repetitive transcranial magnetic stimulation; Val, various kinds of valproic acid; TAP, typical antipsychotics; ZIP, ziprasidone.