ISSN 2586-0151 (Print) | ISSN 2586-0046 (Online)
대한불안의학회지 (20권2호 54-64)
Korean Guidelines for the Treatment of Generalized Anxiety Disorder 2024: Initial and Maintenance Treatment Strategies for the Pharmacological Treatment of Generalized Anxiety Disorder
2024 한국형 범불안장애 치료지침: 초기 및 유지 약물치료 전략
Min-Kyoung Kim1 , Jun Ho Seo2 , Chun Il Park3 , Myung Hee Ahn4 , Hyeon-Ah Lee5 , Yoon Young Chang6 , Eunsoo Moon7 , Ho-Suk Suh8 , Won Kim6 , and Kyoung-Uk Lee9
1 Department of Psychiatry, CHA Ilsan Medical Center, CHA University, Goyang, 2 Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, 3 Department of Psychiatry, Yonsei University College of Medicine, Seoul, 4 Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, Seoul, 5 Department of Psychiatry, College of Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, 6 Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, 7 Department of Psychiatry, Pusan National University School of Medicine, Yangsan, 8 Suh Hosuk Yonsei Psychiatry Clinic for Healthy Mind, Seoul, 9 Department of Psychiatry, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea
Objectives : 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.
Conclusions : 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)
Generalized anxiety disorder; Pharmacological treatment; Initial treatment; Maintenance treatment; Treatment guidelines; Expert consensus.
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