Clin Psychopharmacol Neurosci.
2021 Nov;19(4):751-772. 10.9758/cpn.2021.19.4.751.
Korean Medication Algorithm for Depressive Disorder 2021, Fourth Revision: An Executive Summary
- Seo JS
1 - Bahk WM2
- Woo YS2
- Park YM3
- Kim W4
- Jeong JH2
- Shim SH5
- Lee JG6
- Jang SH7
- Yang CM7
- Wang SM2
- Jung MH8
- Sung HM9
- Choo IH10,11
- Yoon BH12
- Lee SY7
- Jon DI8
- Min KJ1
- Affiliations
-
- 1Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea
- 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 3Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
- 4Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
- 5Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea
- 6Department of Psychiatry, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
- 7Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, Korea
- 8Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
- 9Department of Psychiatry, Soonchunhyang University Gumi Hospital, College of Medicine, Soonchunhyang University, Gumi, Korea
- 10Department of Neuropsychiatry, College of Medicine, Chosun University, Gwangju, Korea
- 11Department of Psychiatry, Chosun University Hospital, Gwangju, Korea
- 12Department of Psychiatry, Naju National Hospital, Naju, Korea
- KMID: 2522984
- DOI: http://doi.org/10.9758/cpn.2021.19.4.751
Abstract
Objective
In the 19 years since the Korean College of Neuropsychopharmacology and the Korean Society for Affective Disorders developed the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) in 2002, four revisions have been conducted.
Methods
To increase survey efficiency in this revision, to cover the general clinical practice, and to compare the results with previous KMAP-DD series, the overall structure of the questionnaire was maintained. The six sections of the questionnaire were as follows: 1) pharmacological treatment strategies for major depressive disorder (MDD) with/without psychotic features; 2) pharmacological treatment strategies for persistent depressive disorder and other depressive disorder subtypes; 3) consensus for treatment-resistant depression; 4) the choice of an antidepressant in the context of safety, adverse effects, and comorbid physical illnesses; 5) treatment strategies for special populations (children/adolescents, elderly, and women); and 6) non-pharmacological biological therapies. Recommended first-, second-, and third-line strategies were derived statistically.
Results
There has been little change in the four years since KMAP-DD 2017 due to the lack of newly introduced drug or treatment strategies. However, shortened waiting time between the initial and subsequent treatments, increased preference for atypical antipsychotics (AAPs), especially aripiprazole, and combination strategies with AAPs yield an active and somewhat aggressive treatment trend in Korea.
Conclusion
We expect KMAP-DD to provide clinicians with useful information about the specific strategies and medications appropriate for treating patients with MDD by bridging the gap between clinical real practice and the evidence-based world.
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