한국형 우울장애 약물치료 알고리듬 2012(V) : 안정성, 부작용, 동반 신체질환을 고려한 항우울제 선택

초록

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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