다양한 임상아형의 우울증 치료에서 항우울제의 선택

Antidepressants in the Treatment of Various Subtypes of Depressive Disorders

본 원고에서는 지금까지의 연구결과들을 바탕으로 우울장애의 각 임상아형에 대한 치료를 개괄해보았다. 안타깝게도 각 임상아형만을 대상으로 한 임상연구들이 매우 부족하기 때문에 아직 임상현장에 많은 도움이 되기는 어렵다는 결론을 내릴 수 있었다. 우울 장애의 다양한 아형에 대한 이해를 넓히고 그에 맞는 차별화된 치료를 제시하기 위해 향후 많은 연구가 필요하다. 이를 통해 우울 장애를 가지고 있는 각 환자들의 개별성을 더 잘 이해하고 우울 장애의 치료에 새로운 도약이 있기를 기대한다.

Depressive disorders have many faces in clinical features, long-term course, prognosis, and the patients with depressive disorders　are not homogeneous group. So, there have been many subtypes of depression suggested and described by clinicians　and researchers. But, there is few evidences which support unique pathophysiology and clinical implication about each subtype.　The treatment of various subtype of depression is not also specified according to scientific evidence. Nowadays, the　rapid development of psychopharmacology and many new antidepressants are making it more possible for clinician to　choose antidepressant according to the subtypes of depression and to the characteristics of patients. Therefore, we reviewed　the clinical evidence of the treatment for various subtypes of depressive disorders and tried to recommend more efficient antidepressant　treatment, although there is a few data for subtypes of depressive disorders. We concluded that the specific　choice of antidepressant for each subtypes of depression is not yet possible, because the current subtyping of depression is　not clear in many aspects, and the clinical trials have focused mainly in depression in a whole. From now on, more efforts is　needed about the more specified subtyping and more specified treatment in order to get more efficacy, safety, and the satisfaction　of patients with depressive disorders.