한국형 우울장애 약물치료 알고리듬 2021 (V)

• 영문명: Korean Medication Algorithm Project for Depressive Disorder 2021 (V): Antidepressant Choices According to Safety, Adverse Effect, Comorbid Physical Illnesses and Clinical Definition of Treatment Resistant Depression
• 발행기관: 대한신경정신의학회
• 저자명: 정명훈(Myung Hun Jung) 이정구(Jung Goo Lee) 박원명(Won-Myong Bahk) 우영섭(Young Sup Woo) 왕성민(Sheng-Min Wang) 정종현
• 간행물 정보: 『신경정신의학』제60권 제4호, 267~274쪽, 전체 8쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2021.11.30

영문 초록

Objectives To revise Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAPDD 2017) guidelines by revising antidepressant choices based on their safety, adverse effects, comorbid physical illnesses, and the clinical definition of treatment-resistant depression (TRD). Methods A 33-item questionnaire comprised of six parts was developed. A 65-expert consensus (65/97, 67.0%) was obtained on pharmacological treatment strategies regarding antidepressant choice with respect to safety, adverse effects, and comorbid physical illnesses. Multiple response sets were subjected to statistical analysis. Results The results obtained showed that first-line pharmacotherapeutic strategies based on various clinical considerations were as follows: mirtazapine (for patients with increased suicidality, Gastrointestinal discomfort, and insomnia), bupropion (for patients with orthostatic hypotension, history of a safety accident, serotonin syndrome, sedation, sexual dysfunction, and weight gain), and escitalopram (for patients with anticholinergic side effects). For patients exhibiting comorbid conditions, duloxetine was the first line pharmacotherapeutic strategy for chronic pain, escitalopram was the first-line pharmacotherapeutic strategy for diabetes, hypertension, liver disease, Parkinson’s disease, renal disease, epilepsy, and thyroid disease, and sertraline was a first-line pharmacotherapeutic strategy for arrhythmia and cardiovascular disease. Conclusion Pharmacological treatment strategy of KMAP-DD 2021 is similar to that of KMAPDD 2017. Additional study is required to determine antidepressant choices for TRD and cancer patients with depression.

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우울증 안전성 부작용 동반 신체질환 치료저항성 우울증 Depressive disorder Safety Adverse effect Comorbid physical iIlness Treatment resistant depression