Korean J Psychopharmacol.
2013 Jan;24(1):18-24.
Korean Medication Algorithm for Depressive Disorder 2012 (III): The Subtypes of Depression
- Affiliations
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- 1Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
- 2Department of Psychiatry, Stress Research Institute, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea.
- 3Shinsegae Hospital, Gimje, Korea.
- 4Department of Psychiatry, Seoul National Hospital, Seoul, Korea.
- 5Department of Psychiatry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
- 6Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 7Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea.
- 8Namwon Sungil Mental Hospital, Namwon, Korea.
- 9Department of Psychiatry, College of Medicine, Hallym University, Anyang, Korea.
- 10Department of Psychiatry, College of Medicine, University of Ulsan, Seoul, Korea.
- 11Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea. kjoonmin@gmail.com
Abstract
OBJECTIVE
Recently, the pharmacotherapy including antidepressants in treating depression is widely used. However, as a result of newer agents that are continuously introduced, pharmacological treatment strategy is also changing. To catch up this trend, Korean Medication Algorithm Project for Depressive Disorder was developed in 2002 and revised in 2006. Since the last revision, the third revision reflected the new research result and the latest trends in the areas of pharmacological treatment.
METHODS
One hundred and twenty three psychiatrists who have vast clinical experiences in depressive disorder are primarily selected then survey was sent to them via mail, 67 surveys were retried. This survey is constructed with 44 questionnaires in which contained from overall treatment strategies to treatment strategies under the specific circumstances. Each treatment strategy or treatment option is evaluated with the overall score of nine and the following 95% confidence interval result treatment option were divided into three phases of recommendation; primary, secondary, tertiary.
RESULTS
For dysthymic disorder, antidepressant monotherapy including selective serotonin reuptake inhibitor (SSRI) [(es)citalopram, fluoxetine, sertraline, paroxetine], serotonin-norepinephrine reuptake inhibitor (SNRI) (venlafaxine, duloxetine, milacipran), and mirtazapine, was recommended as the first line medications. For melancholic type, SSRI, SNRI, and mirtazapine were recommended as the first line medications. For atypical type and seasonal pattern, bupropion as well as SSRI, SNRI, and mirtazapine, were recommended as the first line medications.
CONCLUSION
The preferences of antidepressants in experts were different according to the subtype of depression. These results suggest that clinicians have to consider the subtype of depression in the treatment of depressive disorders.
MeSH Terms
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Antidepressive Agents
Bupropion
Depression
Depressive Disorder
Depressive Disorder, Major
Dysthymic Disorder
Fluoxetine
Mianserin
Postal Service
Psychiatry
Surveys and Questionnaires
Seasons
Serotonin
Sertraline
Thiophenes
Duloxetine Hydrochloride
Antidepressive Agents
Bupropion
Fluoxetine
Mianserin
Serotonin
Sertraline
Thiophenes
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