Korean Medication Algorithm Project for Depressive Disorder 2021 (II): The Subtypes of Depression
10.4306/jknpa.2021.60.3.186
- Author:
Young-Min PARK
1
;
Jeong Seok SEO
;
Young Sup WOO
;
Won-Myong BAHK
;
Won KIM
;
Jong-Hyun JEONG
;
Se-Hoon SHIM
;
Jung Goo LEE
;
Seung-Ho JANG
;
Sheng-Min WANG
;
Myung Hun JUNG
;
Hyung Mo SUNG
;
L Han CHOO
;
Bo-Hyun YOON
;
Sang-Yeol LEE
;
Duk-In JON
;
Kyung Joon MIN
Author Information
1. Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Korean Neuropsychiatric Association
2021;60(3):186-192
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objectives:The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) was developed in 2002 and revised in 2006, 2012, 2017. In 2021, the fifth edition was published.This edition reflected new findings and the latest trends in the areas of pharmacological treatment. The aim of this study is to present strategies and treatment options according to the subtype of depression using data from the KMAP-DD-2021.
Methods:Ninety-seven psychiatrists with clinical experience in depressive disorder were selected. The questionnaires for KMAP-DD 2021 were sent to participants via mail. KMAP-DD 2021 consists of overall treatment strategies and treatment options under specific circumstances.Each treatment strategy or treatment option was evaluated with an overall score of nine and was divided into the three phases of recommendation that include primary, secondary, and tertiary.
Results:For persisting depressive disorder, antidepressant monotherapy including selective serotonin reuptake inhibitor (SSRI) (escitalopram, fluoxetine, sertraline, paroxetine), serotoninnorepinephrine reuptake inhibitor (SNRI) (desvenlafaxine, venlafaxine, duloxetine, milnacipran), vortioxetine, and mirtazapine, was recommended as first-line medications. For melancholia of major depressive disorder, SSRI, SNRI, vortioxetine, and mirtazapine also were recommended as first-line medications. For mixed features, SSRI, bupropion, mirtazapine, SNRI, except for duloxetine, and milnacipran were recommended as first-line medications. For anxious distress, SSRI, mirtazapine, and SNRI, except milnacipran, were recommended as first-line medications.
Conclusion:The preferences of antidepressants by experts differed according to the subtype of depression. These findings suggest that experts treat patients with a major depressive disorder after considering the subtype of depression involved.