Pharmacological therapy of dysthymia

Abstract

Pharmacological therapy of dysthymia. Acta Psychiatr Scand 1994: 89 (suppl. 383): 42-48. ':(> Munksgaard 1994.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.

Comorbidity of obsessive‐compulsive disorder in recovered inpatients with bipolar disorder

“…Serotonin dysfunction has been hypothesized in BD‐II [25,26], OCD [27], dysthymia [28–30], and suicidality [31]. Furthermore, SSRIs are an effective treatment for both OCD [32,33] and dysthymia [34,35], and are reported to provide a more favorable response in the treatment of BD‐II than tricyclic antidepressants [36]. Thus a possible, albeit simplistic, hypothesis would be that a common defect in serotonergic function underlies the combination of symptoms observed in our subjects with comorbid OCD and BD.…”

EEG Sleep Characteristics in Dysthymia and Major Depressive Disorder

“…Along with other clinical and biological observations, our data favor the hypothesis that the two disorders are clinical variants of the same illness. Rates of familial mood disorders [19,20], response to pharmacological treatments [21,22] and clinical courses [3] are not substantially different in the two conditions; also similar biologial features [23], be yond EEG sleep data [8,9,24], have been reported.…”

Amisulpride versus Amineptine and Placebo for the Treatment of Dysthymia

“…As expected from the early onset chronic nature of disturbance, the social and health burden of dysthymia has been found to be considerable and comparable to that of major medical disorders and as such deserves competent pharmacotherapy [2]. The efficacy of active drugs over placebo, evaluated by comparing the ratio of responsiveness, was in the range of 2-3.75 times greater for tricyclic agents (TCAs), selective serotonin reuptake inhibitors (SSRIs) and reversible inhibitors of mono-amine oxidase A (RIMAs) than for placebo [3]. This supports the now generally accepted view that antidepressants should be proposed as the mainstay of the management of dysthymia [4].…”