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KMID : 1007420130110010020
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Mood and Emotion
2013 Volume.11 No. 1 p.20 ~ p.29
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Korean Medication Algorithm for Depressive Disorder (V) : Antidepressant ChoicesAccording to Safety, Adverse Event and Comorbid Physical Illnesses
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Lim Eun-Sung
Song Hoo-Rim
Jeong Jong-Hyun
Lee Hwang-Bin
Park Young-Min
Hong Jeong-Wan
Seo Jeong-Seok
Kim Won
Wang Hee-Ryung
Min Kyung-Joon
Bahk Won-Myong
Hong Jin-Pyo
Jon Duk-In
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Abstract
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Objectives: Since there were the development of new antidepressant and considerable advances in clinical trials and psychopharmacology, the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) need to be revised again in 2012.
Methods: To compare the results between KMAP-DD 2006 and KAMP-DD 2012, the executive committee decided to maintain the same way used in first revision in 2006. The review committee consisted of 123 experienced psychiatrists. From the total of 22 questions in the questionnaire, 2 questions were used for the antidepressant choice according safety and side effect and comorbid 4 physical illnesses. Response rate was 54.5%. Preferred antidepressant was chosen by the review committee's opinion.
Results: 1) According to the side effect, bupropion is preferred for sexual dysfunction, sedation, and weight gain, and mirtazapine for insomnia and GI trouble, and (es)citalopram for anticholinergic side effect. 2) According to safety, (es)citalopram was preferred for cardiovascular disease and seizure, bupropion for serotonin syndrome, and mirtazapine for suicidality. 3) (Es)citalopram and sertraline were preferred for diabetes mellitus, thyroid, liver and renal disease.
Conclusion: These results suggest that clinicians would pay proper attention to choose antidepressant considering the side effect, safety and comorbid physical conditions.
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KEYWORD
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Depressive disorder, Korean medication algorithm, Safety, Side effects, Physical illness
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