Pharmacological therapy of dysthymia.
For a number of years, dysthymia was considered to be non-responsive to antidepressant treatment. During the last decade, early studies with tricyclic antidepressants (TCAs) demonstrated the superiority of the TCAs over placebo. The side effect profile of the TCAs and the moderate degree of symptomatology resulted in reduced compliance and thus to the clinical impression of lack of efficacy. The newest generation of antidepressants, the SRRIs and the RIMAs, with their more acceptable side effect profiles, allowed for the adequate evaluation of pharmacotherapy in dysthymia. The initial open studies with SSRIs indicate a clear efficacy of this group of antidepressants. Likewise, a 5HT2 antagonist, ritanserin, has been shown to be superior to placebo. More recently, a large placebo-controlled study of moclobemide, a RIMA, clearly demonstrated the superiority of this drug over placebo. Based on this evidence, it is now appropriate to consider antidepressants as a clearly effective method of treating dysthymia.
Lapierre
Y D
YD
Department of Psychiatry, Faculty of Medicine, Royal Ottawa Hospital, Ontario, Canada.
D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000150:complications; D001549:Benzamides / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors / Q000627:therapeutic use; D010919:Placebos; D016713:Ritanserin / Q000627:therapeutic use*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use
D000929:Antidepressive Agents, Tricyclic; D001549:Benzamides; D001569:Benzodiazepines; D005473:Fluoxetine; D020912:Moclobemide; D008996:Monoamine Oxidase Inhibitors; D010919:Placebos; D016713:Ritanserin; D017367:Selective Serotonin Reuptake Inhibitors