Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objective The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. Methods We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. Results Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. Conclusion This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.
Abstract
Objective The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea. Methods We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis. Results Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians. Conclusion This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.
참고문헌 (19)
- American Psychiatric Association, "Diagnostic and Statistical Manual of Mental Disorders. 4th ed." (1994), American Psychiatric Press
- Seoul National University Hospital, "The Epidemiological Survey of Psychiatric Illness in Korea 2011" (2011)
- Hwu HG, "Prevalence of psychiatric disorders in Taiwan defined by the Chinese Diagnostic Interview Schedule", Acta Psychiatr Scand, 79, pp.136~147 (1989)[DOI]
- Furmark T, "Social phobia: overview of community surveys", Acta Psychiatr Scand, 105, pp.84~93 (2002)[DOI]
- Kessler RC, "The descriptive epidemiology of commonly occurring mental disorders in the United States", Annu Rev Public Health, 29, pp.115~129 (2008)[DOI]
- Beesdo K, "Incidence of social anxiety disorder and the consistent risk for secondary depression in the first three decades of life", Arch Gen Psychiatry, 64, pp.903~912 (2007)[DOI]
- 김대진, "주요 정신질환의 약물치료에 대한 한국형 알고리듬 개발 (2)- 한국형 알고리듬 개발 사업내용과 기본계획, 조직구성, 알고리듬 개발의 기본원칙, 개발방법, 제한점 및 사용 시 주의점 -", 대한정신약물학회지, 13(1), pp.30~36 (2002), 대한정신약물학회
- Bandelow B, "World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and post-traumatic stress disorders - first revision", World J Biol Psychiatry, 9, pp.248~312 (2008)[DOI]
- Swinson RP, "Clinical practice guidelines - management of anxiety disorders", Can J Psychiatry, 51(8 Suppl 2), pp.9S~91S (2006)[DOI]
- Montgomery SA, "ECNP Consensus Meeting, March 2003. Guidelines for the investigation of efficacy in social anxiety disorder", Eur Neuropsychopharmacol, 14, pp.425~433 (2004)[DOI]
- Western Australian Psychotropic Drugs Committee, "Anxiety Disorders Drug Treatment Guidelines" (2008), Watag
- Stein DJ, "A 2010 evidence-based algorithm for the pharmacotherapy of social anxiety disorder", Curr Psychiatry Rep, 12, pp.471~477 (2010)[DOI]
- Baldwin DS, "Evidence-based guidelines for the pharmacological treatment of anxiety disorders: recommendations from the British Association for Psychopharmacology", J Psychopharmacol, 19, pp.567~596 (2005)[DOI]
- Bandelow B, "World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for the pharmacological treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders", World J Biol Psychiatry, 3, pp.171~199 (2002)[DOI]
- National Collaborating Centre for Mental Health, "Social Anxiety Disorder: The NICE Guideline on Recognition, Assessment and Treatment" (2013)
- Bandelow B, "The diagnosis of and treatment recommendations for anxiety disorders", Dtsch Arztebl Int, 111, pp.473~480 (2014)
- Eccles M, "How to develop cost-conscious guidelines", Health Technol Assess, 5, pp.1~69 (2001)
- Katzman MA, "Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders", BMC Psychiatry, 14(Suppl 1), pp.S1~ (2014)[DOI]
- Woolf SH, "Practice guidelines, a new reality in medicine: II. Methods of developing guidelines", Arch Intern Med, 152, pp.946~952 (1992)[DOI]