한국형 우울장애 약물치료 알고리듬 2025 (II): 임상 아형

• 영문명: Korean Medication Algorithm Project for Depressive Disorder 2025 (II): The Subtypes of Depression
• 발행기관: 대한신경정신의학회
• 저자명: 박성용 김원 박원명 서정석 김낙영 최원석 우영섭 이정구 양찬모 성형모 왕성민 정영은 정종현 민경준 전덕인 윤보현 김문두
• 간행물 정보: 『신경정신의학』제64권 제3호, 193~199쪽, 전체 7쪽
• 주제분류: 의약학 > 정신과학
• 파일형태: PDF
• 발행일자: 2025.08.31

국문 초록

Objectives The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) has been continuously revised. The sixth edition reflected new findings and the latest trends in the areas of pharmacological treatment. This study aimed to suggest strategies and treatment options according to the subtype of depression using data from the KMAP-DD-2025. Methods A total of 136 psychiatrists with clinical experience in depressive disorders were selected. The questionnaires for KMAP-DD 2025 were sent to these participants via mail. The KMAP-DD 2025 comprises 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 three phases of recommendation. Results For persisting depressive disorder, antidepressant monotherapy including selective serotonin reuptake inhibitor (SSRI), serotonin-norepinephrine reuptake inhibitor (SNRI), bupropion, agomelatine, vortioxetine, and mirtazapine, and combination therapy of antidepressants with atypical antipsychotics were recommended as first-line medications. For melancholia of major depressive disorder, SSRI, SNRI, mirtazapine, vortioxetine, milnacipran, bupropion, and agomelatine were recommended as first-line medications. For mixed features, escitalopram, sertraline, desvenlafaxine, fluoxetine, paroxetine, bupropion, aripiprazole, quetiapine, olanzapine, valproate, lithium, and lamotrigine were recommended as first-line medications. For anxious distress, escitalopram, sertraline, paroxetine, desvenlafaxine, venlafaxine, mirtazapine, fluoxetine, duloxetine, aripiprazole, quetiapine, and olanzapine were recommended as first-line medications. Conclusion The preferences of experts regarding antidepressants, mood stabilizers, and antipsychotics differed according to the subtype of depression. These findings suggest that experts treat patients with a major depressive disorder after considering the depression subtype.

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키워드

Korean Medication Algorithm Project Major depressive disorder Persistent depressive disorder Subtype 한국형 약물치료 알고리듬 프로젝트 주요우울장애 지속성 우울장애 하위유형