한국형 우울장애 약물치료 알고리듬 2017(Ⅵ) : 안정성, 부작용, 동반 신체질환을 고려한 항우울제 선택

Abstract

Objectives : This study was undertaken to revise guidelines for the Korean Medication Algorithm Projects for Depressive Disorder 2012 (KMAP-DD 2012). The main purpose of the current study was a revision of the antidepressant choices based on their safety, adverse events and comorbid physical illnesses. Methods : A 44-item questionnaire was developed ; an expert consensus was obtained on the pharmacological treatment strategies regarding the choice of an antidepressant (AD), with respect to its safety and adverse effects. Multiple response sets were used for statistical analysis. Results : Our results showed the 1st line of treatment for various afflictions were as follows: Bupropion (sexual dysfunction), Fluoxetine (sedation), Mirtazapine (control of sleep disturbance and nausea), and Escitalopram (for patients with anticholinergic side effects). For patients exhibiting comorbid conditions, escitalopram was the 1st line of recommendation for diabetes, thyroid disease, liver disease and kidney disease. Conclusion : The pharmacological treatment strategy of KMAP-DD 2017 is similar to KMAP-DD 2012. Particularly noteworthy is that escitalopram was recommended for most of the medical comorbid conditions.

Objectives : This study was undertaken to revise guidelines for the Korean Medication Algorithm Projects for Depressive Disorder 2012 (KMAP-DD 2012). The main purpose of the current study was a revision of the antidepressant choices based on their safety, adverse events and comorbid physical illnesses. Methods : A 44-item questionnaire was developed ; an expert consensus was obtained on the pharmacological treatment strategies regarding the choice of an antidepressant (AD), with respect to its safety and adverse effects. Multiple response sets were used for statistical analysis. Results : Our results showed the 1st line of treatment for various afflictions were as follows: Bupropion (sexual dysfunction), Fluoxetine (sedation), Mirtazapine (control of sleep disturbance and nausea), and Escitalopram (for patients with anticholinergic side effects). For patients exhibiting comorbid conditions, escitalopram was the 1st line of recommendation for diabetes, thyroid disease, liver disease and kidney disease. Conclusion : The pharmacological treatment strategy of KMAP-DD 2017 is similar to KMAP-DD 2012. Particularly noteworthy is that escitalopram was recommended for most of the medical comorbid conditions.