title: The Korean Medication Algorithm for Depressive Disorder: second revision.
abstract: OBJECTIVE
  This study constitutes a revision of the guidelines for the treatment of major depressive disorder (MDD) issued by the Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) 2006. In incorporates changes in the experts׳ consensus that occurred between 2006 and 2012 as well as information regarding newly developed and recently published clinical trials.
  
  
  METHODS
  Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for (1) non-psychotic MDD, (2) psychotic MDD, (3) dysthymia and depression subtypes, (4) continuous and maintenance treatment, and (5) special populations; consensus was also obtained regarding (6) the choice of an antidepressant (AD) in the context of safety and adverse effects, and (7) non-pharmacological biological therapies.
  
  
  RESULTS
  AD monotherapy was recommended as the first-line strategy for nonpsychotic depression in adults, children and adolescents, elderly adults, and patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression. The duration of the initial AD treatment for psychotic depression depends on the number of depressive episodes. Most experts recommended stopping the initial AD and AAP therapy after a certain period in patients with one or two depressive episodes. However, for those with three or more episodes, maintenance of the initial treatment was recommended for as long as possible. Monotherapy with various selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) was recommended for dysthymic disorder and melancholic type MDD.
  
  
  CONCLUSIONS
  The pharmacological treatment strategy of KMAP-DD 2012 is similar to that of KMAP-DD 2006; however, the preference for the first-line use of AAPs was stronger in 2012 than in 2006.
authors.affiliation: Department of Psychiatry, School of Medicine, Konkuk University, Chungju, Korea.
authors.forename: Jeong
authors.initials: J
authors.lastname: Seok Seo
authors.affiliation: Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hoo
authors.initials: H
authors.lastname: Rim Song
authors.affiliation: Department of Psychiatry, Seoul National Hospital, Seoul, Korea.
authors.forename: Hwang
authors.initials: H
authors.lastname: Bin Lee
authors.affiliation: Department of Psychiatry, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea.
authors.forename: Young-Min
authors.initials: YM
authors.lastname: Park
authors.affiliation: Department of Psychiatry, Namwon Sungil Mental Hospital, Namwon, Korea.
authors.forename: Jeong-Wan
authors.initials: JW
authors.lastname: Hong
authors.affiliation: Department of Psychiatry, Seoul Paik Hospital, School of Medicine, Inje University, Seoul, Korea/Stress Research Institute, Inje University, Seoul, Korea.
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hee-Ryung
authors.initials: HR
authors.lastname: Wang
authors.affiliation: Department of Psychiatry, Shinsegae Hospital, KimJe, Korea.
authors.forename: Eun-Sung
authors.initials: ES
authors.lastname: Lim
authors.affiliation: Department of Psychiatry, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
authors.forename: Jong-Hyun
authors.initials: JH
authors.lastname: Jeong
authors.affiliation: Department of Psychiatry, Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
authors.forename: Duk-In
authors.initials: DI
authors.lastname: Jon
authors.affiliation: Department of Psychiatry, College of Medicine, Chung-Ang University, Seoul, Korea. Electronic address: kjoonmin@gmail.com.
authors.forename: Kyung
authors.initials: K
authors.lastname: Joon Min
authors.affiliation: Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young
authors.initials: Y
authors.lastname: Sup Woo
authors.affiliation: Department of Psychiatry, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. Electronic address: wmbahk@catholic.ac.kr.
authors.forename: Won-Myong
authors.initials: WM
authors.lastname: Bahk
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy*; D002648:Child; D015897:Comorbidity; D019052:Depression, Postpartum / Q000188:drug therapy; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D019263:Dysthymic Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065446:Premenstrual Dysphoric Disorder / Q000188:drug therapy; D056910:Republic of Korea; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents
keywords: Algorithm; Depressive disorder; Guideline; Revision