Objectives@#The Korean Medication
Algorithm Project for
Depressive Disorder (KMAP-DD) was developed in 2002 and revised in 2006, 2012, 2017. In 2021, the fifth edition was published.This edition reflected new findings and the latest
trends in the areas of pharmacological
treatment. The aim of this study is to present
strategies and
treatment options according to the subtype of
depression using data from the KMAP-DD-2021. @*
Methods@#Ninety-seven
psychiatrists with clinical experience in
depressive disorder were selected. The
questionnaires for KMAP-DD 2021 were sent to participants via
mail. KMAP-DD 2021 consists of overall
treatment strategies and
treatment options under specific circumstances.Each
treatment strategy or
treatment option was evaluated with an overall score of nine and was divided into the three phases of recommendation that include primary,
secondary, and tertiary. @*Results@#For persisting
depressive disorder,
antidepressant monotherapy including
selective serotonin reuptake inhibitor (SSRI) (
escitalopram,
fluoxetine,
sertraline,
paroxetine), serotoninnorepinephrine reuptake inhibitor (
SNRI) (
desvenlafaxine,
venlafaxine,
duloxetine,
milnacipran),
vortioxetine, and
mirtazapine, was recommended as first-line medications. For
melancholia of
major depressive disorder, SSRI,
SNRI,
vortioxetine, and
mirtazapine also were recommended as first-line medications. For mixed features, SSRI,
bupropion,
mirtazapine,
SNRI, except for
duloxetine, and
milnacipran were recommended as first-line medications. For anxious distress, SSRI,
mirtazapine, and
SNRI, except
milnacipran, were recommended as first-line medications. @*Conclusion@#The preferences of
antidepressants by experts differed according to the subtype of
depression. These findings suggest that experts treat
patients with a
major depressive disorder after considering the subtype of
depression involved.