한국형 우울장애 약물치료 알고리듬 2025 (I): 주요우울삽화의 치료전략

• 영문명: Korean Medication Algorithm Project for Depressive Disorder 2025 (I): Treatment Strategies for Major Depressive Episode
• 발행기관: 대한신경정신의학회
• 저자명: 최원석 우영섭 박원명 김낙영 박성용 김원 이정구 양찬모 성형모 왕성민 정영은 정종현 심세훈 민경준 이상열 전덕인 윤보현 김문두 서정석
• 간행물 정보: 『신경정신의학』제64권 제3호, 178~192쪽, 전체 15쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2025.08.31

국문 초록

Objectives The Korean Medication Algorithm Project for Depressive Disorder 2025 (KMAP-DD 2025) was developed to provide updated, consensus-based pharmacological treatment guidelines for major depressive disorders in Korea, reflecting recent clinical evidence and domestic practice patterns. Methods The Korean Medication Algorithm Project for Depressive Disorder 2025 (KMAP-DD 2025) was developed to provide updated, consensus-based pharmacological treatment guidelines for major depressive disorders in Korea, reflecting recent clinical evidence and domestic practice patterns. Results For mild-to-moderate MDE, antidepressant (AD) monotherapy was recommended as the treatment of choice (TOC), with combination therapies involving mood stabilizers or atypical antipsychotics (AAP) as secondary options. In severe non-psychotic episodes, AD monotherapy, AD plus AAP, and dual AD therapy were all first-line options, while for severe psychotic episodes, AD plus AAP was the TOC. Escitalopram was consistently preferred as the first-line AD, and aripiprazole and quetiapine as leading AAPs. If initial treatments failed, strategies included switching or augmenting with another AD, AAP, or augmentation agents such as lithium, which remained the preferred third-line option. Conclusion Compared to the previous editions, KMAP-DD 2025 showed an increased preference for early combination therapies, especially in more severe or psychotic depression, and a higher reliance on AAPs. These recommendations reflect the evolving clinical trends and the need for practical, context-specific guidance in Korean practice.

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키워드

Major depressive disorder Pharmacotherapy Algorithm 주요우울장애 약물치료 알고리듬