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KMID : 1009020210190040751
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Clinical Psychopharmacology and Neuroscience
2021 Volume.19 No. 4 p.751 ~ p.772
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Korean Medication Algorithm for Depressive Disorder 2021, Fourth Revision: An Executive Summary
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Seo Jeong-Seok
Bahk Won-Myong
Woo Young-Sup
Park Young-Min
Kim Won
Jeong Jong-Hyun
Shim Se-Hoon
Lee Jung-Goo
Jang Seung-Ho
Yang Chan-Mo
Wang Sheng-Min
Jung Myung-Hun
Sung Hyung-Mo
Choo Il-Han
Yoon Bo-Hyun
Lee Sang-Yeol
Jon Duk-In
Min Kyung-Joon
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Abstract
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Objective: In the 19 years since the Korean College of Neuropsychopharmacology and the Korean Society for Affective Disorders developed the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2002, four revisions have been conducted.
Methods: To increase survey efficiency in this revision, to cover the general clinical practice, and to compare the results with previous KMAP-DD series, the overall structure of the questionnaire was maintained. The six sections of the questionnaire were as follows: 1) pharmacological treatment strategies for major depressive disorder (MDD) with/without psychotic features; 2) pharmacological treatment strategies for persistent depressive disorder and other depressive disorder subtypes; 3) consensus for treatment-resistant depression; 4) the choice of an antidepressant in the context of safety, adverse effects, and comorbid physical illnesses; 5) treatment strategies for special populations (children/adolescents, elderly, and women); and 6) non-pharmacological biological therapies. Recommended first-, second-, and third-line strategies were derived statistically.
Results: There has been little change in the four years since KMAP-DD 2017 due to the lack of newly introduced drug or treatment strategies. However, shortened waiting time between the initial and subsequent treatments, increased preference for atypical antipsychotics (AAPs), especially aripiprazole, and combination strategies with AAPs yield an active and somewhat aggressive treatment trend in Korea.
Conclusion: We expect KMAP-DD to provide clinicians with useful information about the specific strategies and medications appropriate for treating patients with MDD by bridging the gap between clinical real practice and the evidence-based world.
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KEYWORD
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Algorithm, Depressive disorder, Guideline, Pharmacotherapy
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