한국형 우울장애 약물치료 알고리듬 2021 (I): 주요우울삽화의 치료 전략
Korean Medication Algorithm Project for Depressive Disorder 2021 (I): Treatment Strategies for Major Depressive Episode
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is a consensus-based medication guideline. To reflect advances in pharmacotherapy for depressive disorders, we have undertaken a fourth revision of the KMAP-DD. Methods The review committee for the new version of the KMAP-DD (KMAP-DD 2021) included 143 Korean psychiatrists with clinical experience in the field of depressive disorders. Each treatment strategy or treatment option was evaluated with an overall score of nine, and the treatment option was categorized into the three levels of recommendation of primary, secondarResults The first-line pharmacotherapeutic strategy for mild to moderate major depressive episodes (MDE) was antidepressant (AD) monotherapy. For severe MDE without psychotic features, AD monotherapy or the combination of AD and atypical antipsychotics (AAP) was the first-line strategy. The combination of AD and AAP was recommended as the first-line for the MDE with psychotic features as well. When treatment response to initial AD monotherapy was insufficient, a combination of AAP or another AD was recommended. In the case of unsatisfactory response to initial treatment with an AD and AAP combination, switching to another AAP or adding another AD was recommended. Conclusion Generally, there were no significant changes in the recommendations for MDE management in the KMAP-DD 2021 compared to previous versions. However, it was notable that the preference for the use of AAP and AD with the novel mechanism of action including vortioxetine and agomelatine increased.y, and tertiary.
Abstract
Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) is a consensus-based medication guideline. To reflect advances in pharmacotherapy for depressive disorders, we have undertaken a fourth revision of the KMAP-DD. Methods The review committee for the new version of the KMAP-DD (KMAP-DD 2021) included 143 Korean psychiatrists with clinical experience in the field of depressive disorders. Each treatment strategy or treatment option was evaluated with an overall score of nine, and the treatment option was categorized into the three levels of recommendation of primary, secondarResults The first-line pharmacotherapeutic strategy for mild to moderate major depressive episodes (MDE) was antidepressant (AD) monotherapy. For severe MDE without psychotic features, AD monotherapy or the combination of AD and atypical antipsychotics (AAP) was the first-line strategy. The combination of AD and AAP was recommended as the first-line for the MDE with psychotic features as well. When treatment response to initial AD monotherapy was insufficient, a combination of AAP or another AD was recommended. In the case of unsatisfactory response to initial treatment with an AD and AAP combination, switching to another AAP or adding another AD was recommended. Conclusion Generally, there were no significant changes in the recommendations for MDE management in the KMAP-DD 2021 compared to previous versions. However, it was notable that the preference for the use of AAP and AD with the novel mechanism of action including vortioxetine and agomelatine increased.y, and tertiary.
참고문헌 (30)
- Lee MS, "The Korean Medication Algorithm for Major Depressive Disorder(KMA-MDD) : report of the Korean Society of Depressive and Bipolar Disorders", Int J Psychiatry Clin Pract, 10, pp.186~194 (2006)
- 서정석, "한국형 우울장애 약물치료 알고리듬 2006 (Ⅰ)", 신경정신의학, 46(5), pp.453~460 (2007), 대한신경정신의학회
- Seo JS, "The Korean Medication Algorithm for Depressive Disorder : second revision", J Affect Disord, 167, pp.312~321 (2014)
- Jeong Seok Seo, "Korean Medication Algorithm for Depressive Disorders 2017: Third Revision", Clinical Psychopharmacology and Neuroscience, 16(1), pp.67~87 (2018), 대한정신약물학회[DOI]
- Sachs GS, "The expert consensus guideline series : medication treatment of bipolar disorder 2000", Postgrad Med, pp.1~104 (2000)
- Brook RH, "A method for the detailed assessment of the appropriateness of medical technologies", Int J Technol Assess Health Care, 2, pp.53~63 (1986)
- Kennedy SH, "Canadian Network for Mood and Anxiety Treatments (CANMAT)2016 clinical guidelines for the management of adults with major depressive disorder: section 3. Pharmacological treatments", Can J Psychiatry, 61, pp.540~560 (2016)
- Bauer M, "Pharmacological treatment of unipolar depressive disorders: summary of WFSBP guidelines", Int J Psychiatry Clin Pract, 21, pp.166~176 (2017)
- Cleare A, "Evidence-based guidelines for treating depressive disorders with antidepressants : a revision of the 2008 British Association for Psychopharmacology guidelines", J Psychopharmacol, 29, pp.459~525 (2015)
- Spielmans GI, "Adjunctive atypical antipsychotic treatment for major depressive disorder : a meta-analysis of depression, quality of life, and safety outcomes", PLoS Med, 10, pp.e1001403~ (2013)
- Catalano G, "Antidepressant augmentation : a review of the literature and a review of the pharmacoeconomic considerations", J Clin Psychopharmacol, 40, pp.396~400 (2020)
- Schulberg HC, "Treating major depression in primary care practice : an update of the Agency for Health Care Policy and Research practice guidelines", Arch Gen Psychiatry, 55, pp.1121~1127 (1998)
- Williams JW Jr, "A systematic review of newer pharmacotherapies for depression in adults : evidence report summary", Ann Intern Med, 132, pp.743~756 (2000)
- Fava M, "Background and rationale for the sequenced treatment alternatives to relieve depression(STAR*D)study", Psychiatr Clin North Am, 26, pp.457~494 (2003)
- Fava M, "Definition and epidemiology of treatmentresistant depression", Psychiatr Clin North Am, 19, pp.179~200 (1996)
- Malhi GS, "A new paradigm for achieving a rapid antidepressant response", Drugs, 80, pp.755~764 (2020)
- Nelson JC, "Atypical antipsychotic augmentation in major depressive disorder : a meta-analysis of placebo-controlled randomized trials", Am J Psychiatry, 166, pp.980~991 (2009)
- Rhee TG, "Antipsychotic prescriptions among adults with major depressive disorder in office-based outpatient settings : national trends from 2006 to 2015", J Clin Psychiatry, 79 (2018)
- Rush AJ, "STAR*D: revising conventional wisdom", CNS Drugs, 23, pp.627~647 (2009)
- Carvalho AF, "The integrative management of treatment-resistant depression : a comprehensive review and perspectives", Psychother Psychosom, 83, pp.70~88 (2014)
- Bschor T, "No evidence for switching the antidepressant : systematic review and meta-analysis of RCTs of a common therapeutic strategy", Acta Psychiatr Scand, 121, pp.174~179 (2010)
- Bobo WV, "Randomized comparison of selective serotonin reuptake inhibitor(escitalopram)monotherapy and antidepressant combination pharmacotherapy for major depressive disorder with melancholic features : a CO-MED report", J Affect Disord, 133, pp.467~476 (2011)
- Rush AJ, "Combining medications to enhance depression outcomes(CO-MED) : acute and long-term outcomes of a single-blind randomized study", Am J Psychiatry, 168, pp.689~701 (2011)
- Friedman ES, "Baseline depression severity as a predictor of single and combination antidepressant treatment outcome : results from the CO-MED trial", Eur Neuropsychopharmacol, 22, pp.183~199 (2012)
- Fava M, "Current status of augmentation and combination treatments for major depressive disorder : a literature review and a proposal for a novel approach to improve practice", Psychother Psychosom, 75, pp.139~153 (2006)
- Bayes AJ, "Comparison of guidelines for the treatment of unipolar depression : a focus on pharmacotherapy and neurostimulation", Acta Psychiatr Scand, 137, pp.459~471 (2018)
- Sakurai H, "Pharmacological management of depression : Japanese expert consensus", J Affect Disord, 266, pp.626~632 (2020)
- Jann MW, "The influence of ethnicity and antidepressant pharmacogenetics in the treatment of depression", Drug Metabol Drug Interact, 16, pp.39~67 (2000)
- Chiara Fabbri, "Genetics of Treatment Outcomes in Major Depressive Disorder: Present and Future", Clinical Psychopharmacology and Neuroscience, 18(1), pp.1~9 (2020), 대한정신약물학회[DOI]
- Bailey RK, "Racial and ethnic differences in depression : current perspectives", Neuropsychiatr Dis Treat, 15, pp.603~609 (2019)