Clinical Psychopharmacology and Neuroscience Papers in Press available online.

 
Korean Medication Algorithm for Depressive Disorder 2021: Fourth Revision
Jeong Seok Seo 1, Won-Myong Bahk 2,*, Young Sup Woo 2, Young-Min Park 3, Won Kim 4, Jong-Hyun Jeong 2, Se-Hoon Shim 5, Jung Goo Lee 6, Seung-Ho Jang 7, Chan-Mo Yang 7, Sheng-Min Wang 2, Myung Hun Jung 8, Hyung Mo Sung 9, IL Han Choo 10, Bo-Hyun Yoon 11, Sang-Yeol Lee 7, Duk-In Jon 8, Kyung Joon Min 1
1Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, 2Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, 3Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, 4Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 5Department of Psychiatry, Soonchunhyang University Cheonan Hospital, College of Medicine, Soonchunhyang University, Cheonan, 6Department of Psychiatry, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, 7Department of Psychiatry, Wonkwang University Hospital, School of Medicine, Wonkwang University, Iksan, 8Department of Psychiatry, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, 9Department of Psychiatry, Soonchunhyang University Gumi Hospital, College of Medicine, Soonchunhyang University, Gumi, 10Department of Neuropsychiatry, College of Medicine, Chosun University, Department of Psychiatry, Chosun University Hospital, Gwangju, 11Department of Psychiatry, Naju National Hospital, Naju, Korea
Abstract
Objective: In the 19 years since the Korean College of Neuropsychopharmacology (KCNP) and the Korean Society for Affective Disorders (KSAD) 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 (AD) 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.
Accepted Manuscript [Submitted on 2021-08-01, Accepted on 2021-08-11]