Anxiety and mood (대한불안의학회지)

Korean Academy of Anxiety Disorders (대한불안의학회)
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Korean Guidelines for the Treatment of Generalized Anxiety Disorder 2024: Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Generalized Anxiety Disorder

2024 한국형 범불안장애 치료지침: 초기 및 유지 약물치료 전략

  • Min-Kyoung Kim (Department of Psychiatry, CHA Ilsan Medical Center, CHA University) ;
  • Jun Ho Seo (Department of Psychiatry, Yonsei University Wonju College of Medicine) ;
  • Chun Il Park (Department of Psychiatry, Yonsei University College of Medicine) ;
  • Myung Hee Ahn (Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center) ;
  • Hyeon-Ah Lee (Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital) ;
  • Yoon Young Chang (Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Eunsoo Moon (Department of Psychiatry, Pusan National University School of Medicine) ;
  • Ho-Suk Suh (Suh Hosuk Yonsei Psychiatry Clinic for Healthy Mind) ;
  • Won Kim (Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kyoung-Uk Lee (Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine)
  • 김민경 (차의과학대학교 정신건강의학교실) ;
  • 서준호 (연세대학교 원주의과대학 정신건강의학교실) ;
  • 박천일 (연세대학교 의과대학 정신과학교실) ;
  • 안명희 (서울아산병원 건강의학과) ;
  • 이현아 (순천향대학교 의과대학 정신건강의학교실) ;
  • 장윤영 (인제대학교 의과대학 정신건강의학교실) ;
  • 문은수 (부산대학교 의과대학 정신건강의학교실) ;
  • 서호석 (서호석연세정신건강의학과) ;
  • 김원 (인제대학교 의과대학 정신건강의학교실) ;
  • 이경욱 (가톨릭대학교 의과대학 정신건강의학교실)
  • Received : 2024.10.21
  • Accepted : 2024.10.29
  • Published : 2024.10.30
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Abstract

Objective : The Korean Association of Anxiety Disorders developed Korean guidelines for the treatment of generalized anxiety disorder (GAD) 2024. In this paper, we discussed the consensus among psychiatrists specializing in anxiety disorders, regarding initial and maintenance treatment strategies for pharmacological treatment of GAD in Korea. Methods : The executive committee developed questionnaires on treatment strategies for patients with GAD, based on previous treatment guidelines and academic articles published internationally and in Korea. Sixty-two experts responded to the questionnaires. The consensus of expert opinions was classified into three categories (first-line, second-line, and third-line choices) using the chi-square test and 95% confidence intervals. Results : Combination of antidepressants and anxiolytics was recommended as treatments of choice (ToC), and antidepressant single pharmacotherapy as first-line strategies for initial treatment of GAD. Several SSRI, SNRI, and mirtazapine were preferred from among many antidepressants, and, among anti-anxiety drugs, clonazepam, alprazolam, buspirone, and lorazepam were first preferred. In the case of maintenance treatment of GAD, antidepressant single pharmacotherapy was selected as ToC and first-line strategies. In addition, it was reported that the preference for atypical antipsychotics was high not only in the initial but also in the maintenance treatment stage as antidepressants and atypical antipsychotics combination treatment maintained the top second-line strategies. Patients were typically examined every four weeks during treatment, to review effectiveness and side effects of the drug. Pharmacotherapy was generally continued for one year or more. Conclusion : This study is based on the clinical experience of Korean experts regarding pharmacological treatment strategies for patients with GAD, and and it is expected to be helpful in presenting the basis and plan for GAD treatment in clinical practice.

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References

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