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Table. 6.

Table. 6.

Maintenance treatment across practice guidelines

Guidelines First-line treatment Next-step intervention Later intervention
KMAP-BP 2022 · Preventing mania: MS, MS + AAP, ARI, QUE, OLA
· Preventing depression: MS + (AAP or LMT), LMT, AAP, MS, AAP + LMT, 2MSs
· Preventing mania: MS + LMT, 2MSs, AAP + LMT, MS + AAP + LMT, LMT
· Preventing depression: MS + AAP + LMT
· Preventing mania: MS + AAP + AD, AAP + AD, MS + AD
· Preventing depression: MS + AAP + AD, MS + AD, AAP + AD
BAP 2016 Li · If mania predominates; Val, OLA, QUE, RIS LAI, CBZ, OXC
· If depression predominates; LMT, QUE
Combination therapy, AD, CLZ, Maintenance ECT
CANMAT 2021 Li, QUE, Val, LMT, ASP, QUE + Li (or Val), ARI + Li (or Val), ARI, ARI OM OLA, RIS LAI, RIS LAI (adj), CBZ, PAL, LUR + Li (or Val), ZIP+ Li (or Val) ARI + LMT, OFC, CLZ (adj), gabapentine (adj)
CINP-BD-2017 Li, ARI, OLA, PAL, QUE, RIS, RIS LAI Add FX or Li, Li + CBZ, QUE + Li (or Val), MS + OLA (or ARI) Add RIS LAI or CBZ or LMT or N-acetylcysteine
NICE 2014 Li Val, OLA, QUE
RANZCP 2020 · Preventing mania: ARI, Li, Val, QUE, ASP, Li + QUE, Val + QUE, Li + ARI
· Preventing depression: LMT, Li, Val, QUE, ASP, Li + QUE, Val + QUE, Li + ARI
· Preventing mania: PAL, RIS, OLA, CBZ, 2MSs, MS + OLA (or RIS or ZIP
· Preventing depression: 2MSs, MS + OLA, MS + LMT, LMT + ARI (or OLA or QUE or FX or LUR)

AAP, atypical antipsychotics; AD, antidepressant; adj, adjunctive; ARI, aripiprazole; ARI OM, aripiprazole once-monthly; ASP, asenapine; BAP 2016, The British Association for Psychopharmacology Guidelines for Treatment for Bipolar Disorder 2016; CANMAT 2018, Canadian Network for Mood and Anxiety Treatments 2018; CBZ, carbamazepine; CINP-BD 2017, The International College of Neuropsychopharmacology Treatment Guidelines for Bipolar Disorder 2017; CLZ, clozapine; ECT, electroconvulsive therapy; FX, fluoxetine; KMAP-BP 2022, Korean Medication Algorithms for Bipolar Disorder 2022; Li, lithium; LMT, lamotrigine; LUR, lurasidone; MS, mood stabilizer; NICE 2014, National Institute for Health and Clinical Excellence Treatment for Bipolar Disorder; OFC, olanzapine-fluoxetine complex; 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; RIS LAI, risperidone long-acting injectable; Val, various kinds of valproic acid; ZIP, ziprasidone.

Korean J Clin Pharm 2023;33:153-67 https://doi.org/10.24304/kjcp.2023.33.3.153
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