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Psychiatry Investig > Volume 15(2); 2018 > Article
Psychiatry Investigation 2018;15(2):147-155.
DOI: https://doi.org/10.30773/pi.2017.05.01    Published online November 29, 2017.
Korean Guidelines for the Pharmacological Treatment of Social Anxiety Disorder: Initial Treatment Strategies
Hyungkun Yoon1, Dong Jae Oh2, Ho-Suk Suh3, Kyoung-Uk Lee4, Se-Won Lim5, Jun-Yeob Lee6, Jong-Chul Yang7, Jae-Hon Lee8.9, Juwon Ha10, Bun-Hee Lee11, Seung-Gul Kang12, Ho-Kyoung Yoon13, Jihyun Moon2, Seung-Min Bae12, Youngdo Kwon14, Hyun-Chung Kim15, Kang Seob Oh5
1Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
2Miso Psychiatric Clinic, Seoul, Republic of Korea
3Department of Psychiatry, School of Medicine, CHA University, CHA Gangnam Medical Center, Seoul, Republic of Korea
4Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Republic of Korea
5Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
6Saebit Hospital, Gyeongju, Republic of Korea
7Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Republic of Korea
8Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea
9Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
10Yonsei Forest Mental Health Clinic, Seoul, Republic of Korea
11Maum & Maum Clinic, Seoul, Republic of Korea
12Department of Psychiatry, Gil Medical Center, Gachon University, School of Medicine, Incheon, Republic of Korea
13Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
14Smart Psychiatry Clinic, Sejong, Republic of Korea
15Department of Psychiatry, National Medical Center of Korea, Seoul, Republic of Korea
Correspondence  Kang Seob Oh ,Tel: +82-2-2001-2214, Fax: +82-2-2001-2211, Email: ks2485@empas.com
Received: January 5, 2017   Revised: March 15, 2017   Accepted: May 1, 2017   Published online: November 29, 2017
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: Social anxiety disorder, Guideline, Initial treatment, Pharmacotherapy
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