한국형 우울장애 약물치료 알고리듬 2017(II) : 정신병적 양상을 동반한 우울장애

Abstract

Objectives : The Korean Medication Algorithm Project for Depressive Disorder 2017 (KMAP-DD 2017) was developed to revise the previous version, the Korean Medication Algorithm Project for Depressive Disorder 2012 (KMAP-DD 2012), to reflect accumulated new findings regarding pharmacotherapy for depression. Methods : A total of 144 psychiatrists with numerous clinical experiences and academic achievements in treating depression were selected. The KMAP-DD 2017 survey was sent to them through e-mail. Of these, 79 answered the survey. The survey consists of seven parts and 44 questions. Each treatment strategy was categorized into three recommendation classifications ; first-line, second-line, and third-line, based on a 95% confidence interval. Results : For psychotic depression, an antidepressant augmented with atypical antipsychotics was selected as the first-line initial treatment. In case of an inadequate treatment response after the first treatment step, switching to another antidepressant, switching to another atypical antipsychotic agent, and adding another antidepressant were selected as first-line treatments. In case of an inadequate treatment response at the second treatment step, switching to another antidepressant, switching to another atypical antipsychotic agent, and adding another antidepressant were selected as first-line treatment options for third step treatment. Conclusion : The KMAP-DD 2017 is expected to provide useful guidance for treating psychotic depression, based on expert consensus and formulated recommendations, enabling clinicians to effectively choose treatment options in clinical practice.