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

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

Author information

1
Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Miso Psychiatric Clinic, Seoul, Republic of Korea.
3
Department of Psychiatry, School of Medicine, CHA University, CHA Gangnam Medical Center, Seoul, Republic of Korea.
4
Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea.
5
Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
6
Saebit Hospital, Gyeongju, Republic of Korea.
7
Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Republic of Korea.
8
Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
9
Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada.
10
Yonsei Forest Mental Health Clinic, Seoul, Republic of Korea.
11
Maum & Maum Clinic, Seoul, Republic of Korea.
12
Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea.
13
Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea.
14
Smart Psychiatry Clinic, Sejong, Republic of Korea.
15
Department of Psychiatry, National Medical Center of Korea, Seoul, Republic of Korea.

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.

KEYWORDS:

Guideline; Initial treatment; Pharmacotherapy; Social anxiety disorder

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