2024 한국형 범불안장애 치료지침: 초기 및 유지 약물치료 전략

초록

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. (Anxiety and Mood 2024;20(2):54-64)

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