한국형 우울장애 약물치료 알고리듬 2025 (II): 임상 아형

• Published in: Singyŏng chŏngsin ŭihak Vol. 64; no. 3; pp. 193 - 199
• Main Author: 박성용(Sung-Yong Park), 김원(Won Kim), 박원명(Won-Myong Bahk), 서정석(Jeong Seok Seo), 김낙영( Nak-Young Kim), 최원석(Won-Seok Choi), 우영섭(Young Sup Woo), 이정구(Jung Goo Lee), 양찬모(Chan-Mo Yang), 성형모(Hyung Mo Sung), 왕성민(Sheng-Min Wang), 정영은(Young-Eun Jung), 정종현(Jong-Hyun Jeong), 민경준(Kyung Joon Min), 전덕인(Duk-In Jon), 윤보현(Bo-Hyun Yoon), 김문두(Moon-Doo Kim)
• Format: Journal Article
• Language: Korean
• Published: 대한신경정신의학회 31.08.2025
• Subjects: 정신과학; 주요우울장애; 지속성 우울장애; Korean Medication Algorithm Project; Persistent depressive disorder; Subtype; 한국형 약물치료 알고리듬 프로젝트; Major depressive disorder; 하위유형
• ISSN: 1015-4817; 2289-0963
• DOI: 10.4306/jknpa.2025.64.3.193

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. KCI Citation Count: 0