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KMID : 0368820130520050372
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Journal of the Korean Neuropsychiatr Association
2013 Volume.52 No. 5 p.372 ~ p.385
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Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (II) : Antidepressant Efficacy Compared with Placebo, Difference in Efficacy of Antidepressants, and Appropriate Time of Efficacy Judgment in Antidepressant Therapy
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Sung Seung-Hwan
Park Seon-Cheol
Han Kyu-Man
Won Eun-Soo
Lee Hwa-Young
Koo Jae-Woo
Paik Jong-Woo
Lee Kyung-Min
Jeon Hong-Jin
Lee Moon-Soo
Shim Se-Hoon
Ko Young-Hoon
Lee Kang-Joon
Han Chang-Su
Ham Byung-Joo
Choi Joon-Ho
Hwang Tae-Yeon
Oh Kang-Seob
Park Yong-Chon
Lee Min-Soo
Han Sang-Woo
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Abstract
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Objectives: The purpose of this study was to suggest recommendations of antidepressant efficacy compared with placebo, difference in efficacy of antidepressants, and appropriate time of efficacy judgment in antidepressant therapy.
Methods: Using recommendations from 12 international and domestic clinical practice guidelines for depression, drawing of recommendation drafts, and peer review, the executive committee developed the guideline.
Results: Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOI), selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and specific serotonergic antidepressants (NaSSAs), norepinephrine and dopamine reuptake inhibitors (NDRIs), and serotonin antagonist and reuptake inhibitors (SARIs) were strongly recommended as having antidepressant efficacy compared with placebo. Difference in efficacy of antidepressants was as follows. TCAs, MAOI, SSRI, SNRIs, and NaSSAs were strongly recommended, however, NDRIs, SARIs were weakly recommended. If there was no or minimal improvement with treatment, appropriate time of efficacy judgment in antidepressant therapy was estimated to be after two to four weeks.
Conclusion: We hope that the results of this study will be helpful in encouraging the optimal treatment by understanding antidepressant efficacy compared with placebo, difference in efficacy of antidepressants, and appropriate time of efficacy judgment in antidepressant therapy.
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KEYWORD
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Major depressive disorder, Guideline, Antidepressant, Placebo, Difference in efficacy, Appropriate time, Efficacy judgment
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