Korean Medication Algorithm Project for Generalized Anxiety Disorder 2009 (II) : Medication Algorithm & Long-Term Medication Treatment Strategy.
- Author:
Jun Yeob LEE
1
;
Min Sook KIM
;
Sang Hyuk LEE
;
Jong Chul YANG
;
Chan Hyung KIM
;
Bum Hee YU
;
Ho Suk SUH
Author Information
1. Department of Psychiatry, School of Medicine, CHA University, Seoul, Korea. freud@chol.com
- Publication Type:Original Article
- Keywords:
Generalized anxiety disorder;
Psychopharmacology;
Algorithm;
Long-term medication treatment strategy;
Korean Medication Algorithm Project
- MeSH:
Alprazolam;
Anxiety;
Anxiety Disorders;
Benzodiazepines;
Buspirone;
Citalopram;
Clonazepam;
Consensus;
Cyclohexanols;
Expert Testimony;
Fluoxetine;
Humans;
Mianserin;
Norepinephrine;
Paroxetine;
Psychopharmacology;
Surveys and Questionnaires;
Serotonin;
Sertraline;
Venlafaxine Hydrochloride
- From:Journal of Korean Neuropsychiatric Association
2010;49(6):553-563
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
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.
