Korean Medication Algorithm for Depressive Disorder 2025, Fifth Revision: An Executive Summary

Area of Science:

• Neuroscience
• Psychiatry
• Pharmacology

Background:

• The Korean Medication Algorithm Project for Depressive Disorder (KMAP-DD) has been revised five times since 2002.
• It is developed by the Korean College of Neuropsychopharmacology and the Korean Society for Affective Disorders.

Purpose of the Study:

• To update treatment recommendations for depressive disorders.
• To maintain survey efficiency and reflect current clinical practices.
• To facilitate comparisons with previous KMAP-DD revisions.

Main Methods:

• The study retained the overall structure of the KMAP-DD questionnaire.
• Six sections covered pharmacological treatments, treatment-resistant depression, antidepressant selection, special populations, and non-pharmacological therapies.
• Treatment recommendations were statistically derived for first-, second-, and third-line options.

Main Results:

• Minor changes were observed compared to KMAP-DD 2021 due to limited new medications.
• A notable shift included increased preference for atypical antipsychotics (AAPs).
• There was a higher preference for combination strategies involving AAPs and mood stabilizers, indicating a more intensive treatment trend.

Conclusions:

• The KMAP-DD provides expert consensus-based recommendations for depressive disorder treatment.
• It serves as a clinical resource for pharmacological options and specific treatment strategies.
• The project supports integrating real-world practice with evidence-based medicine.