양극성장애에서 Antipsychotics의 사용 전략

• 영문명: Strategies of Using Antipsychotics in Patients with Bipolar Disorders
• 발행기관: 대한신경정신의학회
• 저자명: 전홍진(Hong Jin Jeon)
• 간행물 정보: 『신경정신의학』제57권 제4호, 301~307쪽, 전체 7쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2018.11.30

영문 초록

Bipolar disorder is a recurrent chronic condition and patients usually continue long-term medication from young age to prevent the recurrence of mood episodes. Antipsychotics play an important role in acute and maintenance treatment of bipolar disorder, even when patients experience no psychotic symptoms. Antipsychotics are also used in monotherapy and combination therapy involving mood stabilizers such as lithium or valproate. However, limited antipsychotics are currently approved by the US Food & Drug Administration ; 10 kinds of antipsychotics were approved for manic or mixed episodes, 3 for bipolar depression, and 5 for maintenance therapy. Before and after the use of antipsychotics, psychiatrists should carefully monitor baseline weight, pulse, blood pressure, fasting blood glucose or HbA1c, blood lipid profile, and electrocardiogram to evaluate QTc prolongation. During manic episodes or mixed features, antipsychotics rapidly control agitation, aggression, and impulsivity. Repetitive injections of typical antipsychotics are not implemented in bipolar patients as this practice is not evidence-based. However, long-acting injectable atypical antipsychotics are approved and feature support on maintenance therapy for bipolar patients. Although recent studies have shown the benefits of aripiprazole and olanzapine on rapid-cycling bipolar patients, few studies support the effectiveness of antipsychotics in suicide prevention. Moreover, while there is extensive evidence on the effectiveness of lithium in suicide or self-harm prevention. In conclusion, antipsychotics, especially aripiprazole, quetiapine, olanzapine, and risperidone, are effective to manage bipolar disorder in clinical settings. But weight gain and cardiac conductance should be carefully monitored before and during the use of antipsychotics.

목차

서론

양극성장애에서 항정신병약물의 승인 내용 및 사용 전 평가

양극성장애에서 항정신병약물의 선택

급성 조증상태

결론

키워드

Bipolar disorder Food & Drug Administration QTc prolongation Metabolic syndrome Mania Mixed Depression Maintenance 양극성장애 식품의약품안전청 QTc 연장 대사증후군 조증 혼재성 양상 우울삽화 유지기