Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (I) : Initial Choice of Antidepressant Treatment

Seon-Cheol Park; Seung-Hwan Sung; Kyu-Man Han; Eun-Soo Won; Hwa-Young Lee; Jong-Woo Paik; Hong Jin Jeon; Moon-Soo Lee; Se-Hoon Shim; Young-Hoon Ko; Kang-Joon Lee; Changsu Han; Byung-Joo Ham; Joonho Choi; Heeyoung Lee; Tae-Yeon Hwang; Kang-Seob Oh; Yong-Chon Park; Min-Soo Lee; Sang-Woo Hahn

doi:10.4306/jknpa.2013.52.4.253

Journal List > J Korean Neuropsychiatr Assoc > v.52(4) > 1017637

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Park, Sung, Han, Won, Lee, Paik, Jeon, Lee, Shim, Ko, Lee, Han, Ham, Choi, Lee, Hwang, Oh, Park, Lee, and Hahn: Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (I) : Initial Choice of Antidepressant Treatment

Original Article

Journal of Korean Neuropsychiatric Association

Journal of Korean Neuropsychiatric Association 2013; 52(4): 253-262.

Published online: 31 July 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.4.253

Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (I) : Initial Choice of Antidepressant Treatment

Seon-Cheol Park, MD, PhD¹, Seung-Hwan Sung, MD², Kyu-Man Han, MD³, Eun-Soo Won, MD³, Hwa-Young Lee, MD, PhD², Jong-Woo Paik, MD, PhD⁴, Hong Jin Jeon, MD, PhD⁵, Moon-Soo Lee, MD, PhD⁶, Se-Hoon Shim, MD, PhD², Young-Hoon Ko, MD, PhD⁷, Kang-Joon Lee, MD, PhD⁸, Changsu Han, MD, PhD⁷, Byung-Joo Ham, MD, PhD³, Joonho Choi, MD, PhD⁹, Heeyoung Lee, MD, MPH¹⁰, Tae-Yeon Hwang, MD, PhD¹, Kang-Seob Oh, MD, PhD¹¹, Yong-Chon Park, MD, PhD⁹, Min-Soo Lee, MD, PhD³, Sang-Woo Hahn, MD, PhD¹²

¹Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea.

²Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Korea.

³Department of Psychiatry, College of Medicine, Korea University, Anam Hospital, Seoul, Korea.

⁴Department of Psychiatry, School of Medicine, KyungHee University, KyungHee University Medical Center, Seoul, Korea.

⁵Department of Psychiatry, School of Medicine, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea.

⁶Department of Psychiatry, College of Medicine, Korea University, Guro Hospital, Seoul, Korea.

⁷Department of Psychiatry, College of Medicine, Korea University, Ansan Hospital, Ansan, Korea.

⁸Department of Psychiatry, College of Medicine, Inje University, Ilsan Baik Hospital, Ilsan, Korea.

⁹Department of Psychiatry, College of Medicine, Hanyang University, Guri Hospital, Guri, Korea.

¹⁰Department of Cancer Control, Gachon University Gil Medical Center, Incheon, Korea.

¹¹Department of Psychiatry, School of Medicine, Sungkyunkwan University, Kangbuk Samsung Medical Center, Seoul, Korea.

¹²Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul Hospital, Seoul, Korea.

Address for correspondence: Sang-Woo Hahn, MD, PhD, Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul Hospital, 59 Daesagwan-ro, Yongsan-gu, Seoul 140-743, Korea. Tel: +82-2-709-9234, Fax: +82-2-794-9414, ha5hn@schmc.ac.kr

Received 20 June 2013 Revised 2 July 2013 Accepted 3 July 2013

Abstract

Objectives

The aim of this study is to establish Korean pharmacological treatment guidelines for the initial choice of antidepressant for treatment of moderate or severe depression.

Methods

The process for establishment of guidelines involved determination of important key questions, selection of 12 international and domestic clinical practice guidelines for depression, drawing of recommendation drafts, and peer review.

Results

Selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), norepinephrine-dopamine reuptake inhibitors (NDRI), and noradrenergic and specific serotonergic antidepressants (NaSSA) were strongly recommended as the first-line antidepressants for treatment of moderate or severe depression. SSRIs were weakly recommended for patients who had problems with tolerability. Consideration of not only efficacy but also provisional adverse effects, drug-drug interactions, history of treatment response, preference, acceptability, cost, comorbid illnesses, and other factors in the choice of first-line antidepressants was strongly recommended. The treatment recommendations for specific clinical features of depression were as follows. SSRIs were weakly recommended for atypical depression. Augmented use of antipsychotics to antidepressants was strongly recommended for psychotic depression. Bupropion and SSRIs were weakly recommended for seasonal depression.

Conclusion

The results of this study may contribute toward improving the quality of depression treatment by providing clear and definite recommendations for the initial choice of antidepressant for treatment of moderate or severe depression.

Keywords: Depression, Pharmacological treatment, Antidepressant, Initial choice, Korean

Figures and Tables

Fig. 1

Searching and selection of clinical practice guidelines for depression.

Table 1

Twelve clinical practice guidelines for depression after the process of searching and selection

Acknowledgments

This study was supported by a grant of the Korean Health 21 Care Technology R & D Project, Ministry of Health and Welfare, Republic of Korea (A102065).

Notes

The authors have no financial conflicts of interest.

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