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근거중심 한국형 우울증 약물학적 치료지침, 개정판(III) : 항우울제의 증량, 교체, 병합 및 강화요법

Title
근거중심 한국형 우울증 약물학적 치료지침, 개정판(III) : 항우울제의 증량, 교체, 병합 및 강화요법
Author
최준호
Keywords
주요우울장애; 진료지침; 항우울제; 증량; 교체; 병합요법; 강화요법; Major depressive disorder; Guideline; Antidepressant; Switching; Combination; Augmentation
Issue Date
2013-09
Publisher
대한신경정신의학회(THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)
Citation
신경정신의학, Vol.52 No.5 [2013], 386-401
Abstract
Objectives The aim of this study was to demonstrate the recommendations for antidepressant treatment strategy of dose increment, switching, combination, and augmentation therapy derived from Evidence-Based Korean Pharmacological Treatment Guideline for Depression, Revised Edition.Methods The guideline was developed through adaptation of 12 domestic and foreign clinical guidelines for depression, with key questions concerning pharmacotherapy of depression, and drawing of recommendations.Results The guideline strongly recommended dose increment, switching, and combination and augmentation therapy of antidepressant when patients with depression showed inadequate treatment outcomes from initial antidepressant treatment. The dose increment was strongly recommended when the patients had insufficient response from treatment with tricyclic antidepressants (TCAs), monoamine oxidase inhibitors, selective serotonin reuptake inhibitors (SSRIs), and serotonin and norepinephrine reuptake inhibitors (SNRIs). Switching from SSRI to non-SSRI was also strongly recommended. The combination of initial medication and other classes of antidepressants could benefit from treatment with TCAs, SSRIs, SNRIs, and noradrenergic and specific serotonergic antidepressants. Combination with norepinephrine and dopamine reuptake inhibitors or serotonin-2 antagonist/reuptake inhibitors was weakly recommended. The guideline strongly recommended use of the augmentation strategy of adding lithium or benzodiazepine to initial antidepressants. Augmentation of lamotrigine, T3, methylphenidate, and modafinil was weakly recommended.Conclusion If the initial outcomes of antidepressant therapy are unsatisfactory to the patients the next-step strategies of dose increment, switching, combination and augmentation of antidepressants should be considered after rechecking the patients’ drug compliance, dose, and diagnosis.
URI
https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001812130http://hdl.handle.net/20.500.11754/44671
ISSN
1015-4817
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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