한국형 우울장애 약물치료 알고리듬 2017(VII) : 비약물학적 생물치료

Abstract

Objectives : Depression is widely managed by pharmacological treatments. However, due to the continuous introduction of newer agents, pharmacological treatment strategies are also changing. Methods : A survey was emailed to 144 psychiatrists having vast clinical experiences in depressive disorders. Of these, 79 surveys were repeated. Results : Electroconvulsive therapy (ECT) was recommended as the initial strategy for major depressive disorder, and for severe cases showing suicidal risk but without any accompanying psychotic features. It was considered as a second strategy for non-responders on antidepressant monotherapy or combination therapy, associated with other physical illness. In cases with major depressive disorders and those with severe psychotic features, ECT was preferred as a treatment of choice for patients showing urgent suicidal risk ; however, it was the second strategy for nonresponders on antipsychotics and antidepressants combination therapy, and combined with physical illness. Conclusion : ECT was the preferred initial strategy in severe episode with/without psychotic features having urgent suicidal risk, and was the second choice in case of non-responders, associated with physical illness and pregnancy. Combination with complementary therapy was a second strategy for treating refractory patients

Objectives : Depression is widely managed by pharmacological treatments. However, due to the continuous introduction of newer agents, pharmacological treatment strategies are also changing. Methods : A survey was emailed to 144 psychiatrists having vast clinical experiences in depressive disorders. Of these, 79 surveys were repeated. Results : Electroconvulsive therapy (ECT) was recommended as the initial strategy for major depressive disorder, and for severe cases showing suicidal risk but without any accompanying psychotic features. It was considered as a second strategy for non-responders on antidepressant monotherapy or combination therapy, associated with other physical illness. In cases with major depressive disorders and those with severe psychotic features, ECT was preferred as a treatment of choice for patients showing urgent suicidal risk ; however, it was the second strategy for nonresponders on antipsychotics and antidepressants combination therapy, and combined with physical illness. Conclusion : ECT was the preferred initial strategy in severe episode with/without psychotic features having urgent suicidal risk, and was the second choice in case of non-responders, associated with physical illness and pregnancy. Combination with complementary therapy was a second strategy for treating refractory patients