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韩国社交焦虑障碍药物治疗指南:初始治疗策略

Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies.

作者信息

Yoon Hyungkun, Oh Dong Jae, Suh Ho-Suk, Lee Kyoung-Uk, Lim Se-Won, Lee Jun-Yeob, Yang Jong-Chul, Lee Jae-Hon, Ha Juwon, Lee Bun-Hee, Kang Seung-Gul, Yoon Ho-Kyoung, Moon Jihyun, Bae Seung-Min, Kwon Youngdo, Kim Hyun-Chung, Oh Kang Seob

机构信息

Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Miso Psychiatric Clinic, Seoul, Republic of Korea.

出版信息

Psychiatry Investig. 2018 Feb;15(2):147-155. doi: 10.30773/pi.2017.05.01. Epub 2017 Nov 29.

Abstract

OBJECTIVE

The aim of the present study was to provide clinical consensus and evidence regarding initial treatment strategies for the pharmacological treatment of social anxiety disorder (SAD) in Korea.

METHODS

We prepared a questionnaire to derive a consensus from clinicians regarding their preference for the pharmacological treatment of SAD in Korea. Data regarding medication regimens and psychotropic drugs used during initial treatment, the doses used, and the pharmacological treatment duration were obtained. Responses were obtained from 66 SAD experts, and their opinions were classified into three categories (first-line, second-line, third-line) using a chi-square analysis.

RESULTS

Clinicians agreed upon first-line regimens for SAD involving monotherapy with selective serotonin reuptake inhibitors (SSRIs) or the serotonin-norepinephrine reuptake inhibitor (SNRI) venlafaxine, or combined therapy using antidepressants with betablockers or benzodiazepines on a standing or as-needed basis. First-line psychotropic drug choices for initial treatment included the following: escitalopram, paroxetine, sertraline, venlafaxine, and propranolol. The medication dosage used by domestic clinicians was found to be comparable with foreign guidelines. Domestic clinicians tended to make treatment decisions in a shorter amount of time and preferred a similar duration of maintenance treatment for SAD when compared with foreign clinicians.

CONCLUSION

This study may provide significant information for developing SAD pharmacotherapy guidelines in Korea, especially in the early stage of treatment.

摘要

目的

本研究旨在为韩国社交焦虑障碍(SAD)药物治疗的初始治疗策略提供临床共识和证据。

方法

我们编制了一份问卷,以征求临床医生对韩国SAD药物治疗偏好的共识。获取了有关初始治疗期间使用的药物治疗方案、精神药物、使用剂量和药物治疗持续时间的数据。从66名SAD专家处获得了答复,并使用卡方分析将他们的意见分为三类(一线、二线、三线)。

结果

临床医生就SAD的一线治疗方案达成共识,包括使用选择性5-羟色胺再摄取抑制剂(SSRIs)或5-羟色胺-去甲肾上腺素再摄取抑制剂(SNRI)文拉法辛进行单药治疗,或根据情况需要使用抗抑郁药与β受体阻滞剂或苯二氮䓬类药物联合治疗。初始治疗的一线精神药物选择包括:艾司西酞普兰、帕罗西汀、舍曲林、文拉法辛和普萘洛尔。发现国内临床医生使用的药物剂量与国外指南相当。与国外临床医生相比,国内临床医生倾向于在更短的时间内做出治疗决策,并且对SAD维持治疗的持续时间有相似的偏好。

结论

本研究可能为韩国制定SAD药物治疗指南提供重要信息,尤其是在治疗的早期阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d72/5900408/71f9371a3a7e/pi-2017-05-01f1.jpg

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