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KMID : 0368820100490060553
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Journal of the Korean Neuropsychiatr Association
2010 Volume.49 No. 6 p.553 ~ p.563
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Korean Medication Algorithm Project for Generalized Anxiety Disorder 2009 (II) : Medication Algorithm & Long-Term Medication Treatment Strategy
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Lee Jun-Yeop
Gim Min-Sook
Lee Sang-Hyuk
Yang Jong-Chul
Kim Chan-Hyung
Yu Bum-Hee
Suh Ho-Suk
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Abstract
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Objectives: This study was performed to investigate the consensus about medication algorithms, including long-term medication treatment strategies, in the treatment of generalized anxiety disorder (GAD).
Methods: The executive committee of the Korean Medication Algorithm Project for GAD developed questionnaires about the psychopharmacologic treatment strategies for patients with GAD. Fifty-five (65%) of 84 experts of a reviewing committee answered the questionnaires. The consensus of expert opinion was classified into three categories, and the treatments of choice were selected by use of 95% confidence intervals and chi-square-tests.
Results: The consensus on the first-line treatment strategy for GAD was as follows. Step 1 is the use of the one of a selective serotonin reuptake inhibitor (SSRI), a serotonin and noradrenaline reuptake inhibitor (SNRI) and buspirone for at least four to six weeks. Step 2 is to switch from a SSRI to a SNRI or buspirone or vice versa. Step 3 is to augment medication with an atypical antipsychotic or add a benzodiazepine or antihistamine. Step 4 is to switch to another combination, which includes a SSRI, a SNRI, mirtazapine or a tricyclic antidepressant Step 6 is to review the diagnosis, and ’benzodiazepines including clonazepam and alprazolam can be combined with another drug even from the initial period’. In terms of long-term medication treatment, the consensus first-line tr-eatment strategy involved the use of venlafaxine XR, escitalopram, fluoxetine, paroxetine CR, sertraline and buspirone.
Conclusion: This study provided information about the consensus among Korean experts regarding medication algorithms, including long-term medication treatment strategies, in the treatment of GAD.
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KEYWORD
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Generalized anxiety disorder, Psychopharmacology, Algorithm, Long-term medication treatment strategy, Korean Medication Algorithm Project
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