Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (II) : Antidepressant Efficacy Compared with Placebo, Difference in Efficacy of Antidepressants, and Appropriate Time of Efficacy Judgment in Antidepressant Therapy

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

doi:10.4306/jknpa.2013.52.5.372

Journal List > J Korean Neuropsychiatr Assoc > v.52(5) > 1017653

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Sung, Park, Han, Won, Lee, Koo, Paik, Lee, Jeon, Lee, Shim, Ko, Lee, Han, Ham, Choi, Hwang, Oh, Park, Lee, and Hahn: Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (II) : Antidepressant Efficacy Compared with Placebo, Difference in Efficacy of Antidepressants, and Appropriate Time of Efficacy Judgment in Antidepressant Therapy

Original Article

Journal of Korean Neuropsychiatric Association 2013; 52(5): 372-385.

Published online: 30 September 2013

DOI: https://doi.org/10.4306/jknpa.2013.52.5.372

Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition (II) : Antidepressant Efficacy Compared with Placebo, Difference in Efficacy of Antidepressants, and Appropriate Time of Efficacy Judgment in Antidepressant Therapy

Seung-Hwan Sung, MD¹, Seon-Cheol Park, MD, PhD², Kyu-Man Han, MD³, Eun-Soo Won, MD³, Hwa-Young Lee, MD, PhD¹, Jae-Woo Koo, MD², Jong-Woo Paik, MD, PhD⁴, Kyung-Min Lee, MD², Hong Jin Jeon, MD, PhD⁵, Moon-Soo Lee, MD, PhD³, Se-Hoon Shim, MD, PhD¹, Young-Hoon Ko, MD, PhD³, Kang-Joon Lee, MD, PhD⁶, Changsu Han, MD, PhD³, Byung-Joo Ham, MD, PhD³, Joonho Choi, MD, PhD⁷, Tae-Yeon Hwang, MD, PhD², Kang-Seob Oh, MD, PhD⁵, Yong-Chon Park, MD, PhD⁷, Min-Soo Lee, MD, PhD³, Sang-Woo Hahn, MD, PhD⁸

¹Department of Psychiatry, College of Medicine, Soonchunhyang University, Cheonan, Korea.

²Department of Psychiatry, Yong-In Mental Hospital, Yongin, Korea.

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

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

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

⁶Department of Psychiatry, College of Medicine, Inje University, Busan, Korea.

⁷Department of Psychiatry, College of Medicine, Hanyang University, Seoul, Korea.

⁸Department of Psychiatry, College of Medicine, Soonchunhyang University, Seoul, Korea.

Address for correspondence: Sang-Woo Hahn, MD, PhD. Department of Psychiatry, 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 4 August 2013 Revised 22 August 2013 Accepted 22 August 2013

Abstract

Objectives

The purpose of this study was to suggest recommendations of antidepressant efficacy compared with placebo, difference in efficacy of antidepressants, and appropriate time of efficacy judgment in antidepressant therapy.

Methods

Using recommendations from 12 international and domestic clinical practice guidelines for depression, drawing of recommendation drafts, and peer review, the executive committee developed the guideline.

Results

Tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOI), selective serotonin reuptake inhibitors (SSRI), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine and specific serotonergic antidepressants (NaSSAs), norepinephrine and dopamine reuptake inhibitors (NDRIs), and serotonin antagonist and reuptake inhibitors (SARIs) were strongly recommended as having antidepressant efficacy compared with placebo. Difference in efficacy of antidepressants was as follows. TCAs, MAOI, SSRI, SNRIs, and NaSSAs were strongly recommended, however, NDRIs, SARIs were weakly recommended. If there was no or minimal improvement with treatment, appropriate time of efficacy judgment in antidepressant therapy was estimated to be after two to four weeks.

Conclusion

We hope that the results of this study will be helpful in encouraging the optimal treatment by understanding antidepressant efficacy compared with placebo, difference in efficacy of antidepressants, and appropriate time of efficacy judgment in antidepressant therapy.

Keywords: Major depressive disorder, Guideline, Antidepressant, Placebo, Difference in efficacy, Appropriate time, Efficacy judgment

Figures and Tables

Table 1

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

Table 2

Evidence levels and recommendation level of twelve clinical practice guidelines for depression

Acknowledgments

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

Notes

The authors have no financial conflicts of interest.

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