한국형 우울장애 약물치료 알고리듬 2006 (I)

• 영문명: Korean Medication Algorithm for Depressive Disorder 2006 (I)
• 발행기관: 대한신경정신의학회
• 저자명: 서정석 민경준 김원 석정호 박원명 송해철 이상열 전덕인 전현태 홍진표 한국형 우울장애 약물치료 알고리듬 2006 연구그룹
• 간행물 정보: 『신경정신의학』제46권 제5호, 453~460쪽, 전체 8쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2007.09.30

영문 초록

Objectives：Since the publication of Korean Medication Algorithm Project for Major depressive Disorder (KMAP-MD) in 2002, there has been a substantial need for a revision due to rapid progress in the pharmacological management for depressive disorder. We revised KMAP-MD to Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2006. This paper is one of the following 4 papers consisting of Korean pharmacological algorithm for depressive disorder. Methods：The questionnaire consisted of 4 parts; initial treatment of 1) non-psychotic depressive disorder, 2) psychotic depressive disorder, 3) treatment strategy for clinical subtypes and drug choice considering adverse effects, and 4) treatment for depressive disorder in women. It was composed of 22 questions, and each question had 54 sub-items. The questionnaire was completed by the review committee consisting of 101 experienced Korean psychiatrists. We classified the expert opinion to 3 categories (the first-line, the second-line, or the third-line). Results：For non-psychotic major depression, regardless of the severity of an episode, the antidepressant (AD) monotherapy was the optimal first-line treatment. SSRI, venlafaxine, and mirtazapine were the 1st-line AD. In case of a partial or no response to initial strategy, adding another AD was recommended. For psychotic major depression, combination of an AD and an atypical antipsychotic (AAP) was the treatment of choice. Among AAPs, quetiapine, risperidone, olanzapine were preferred. For nonresponder to initial strategy, the next step was adding or changing AD before changing AAP. For women with premenstrual dysphoric syndrome or postpartum depression without psychotic features, AD monotherapty was a preferred strategy while for psychotic postpartum depression, combination of AD and AAP was recommended. Experts recommended various ADs according to adverse effect. Conclusion：These results suggest that the medication strategies for depressive disorder are rapidly changing and reflect the recent studies and clinical experiences.

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키워드

Depressive disorder Korean Medication Algorithm Revision