Venlafaxine in the Treatment of Dysthymia

Hellerstein, David J.; Batchelder, Sarai; Little, Suzanne; Fedak, M.; Kreditor, David; Rosenthal, Jesse

doi:10.4088/jcp.v60n1207

Cited by 20 publications

(11 citation statements)

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“…The positive clinical response to medications like selective serotonin reuptake inhibitors (SSRIs) [12–19], serotonin norepinephrine reuptake inhibitors (SNRIs) [20, 21], and tricyclic antidepressants (TCAs) [14, 15] suggests that serotoninergic and noradrenergic systems involve the mechanism of dysthymia. A systematic review [22, 23] of antidepressant treatment for dysthymia suggests that SSRIs, TCAs, and monoamine oxidase inhibitors are all equally effective, but SSRIs may be slightly better tolerated.…”

Section: Treatment For Dysthymiamentioning

confidence: 99%

Dysthymia and Apathy: Diagnosis and Treatment

Ishizaki

Mimura

2011

Depression Research and Treatment

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Dysthymia is a depressive mood disorder characterized by chronic and persistent but mild depression. It is often difficult to be distinguished from major depression, specifically in its partially remitted state because “loss of interest” or “apathy” tends to prevail both in dysthymia, and remitted depression. Apathy may also occur in various psychiatric and neurological disorders, including schizophrenia, stroke, Parkinson's disease, progressive supranuclear palsy, Huntington's disease, and dementias such as Alzheimer's disease, vascular dementia, and frontotemporal dementia. It is symptomatologically important that apathy is related to, but different from, major depression from the viewpoint of its causes and treatment. Antidepressants, especially noradrenergic agents, are useful for depression-related apathy. However, selective serotonin reuptake inhibitors (SSRIs) may be less effective for apathy in depressed elderly patients and have even been reported to worsen apathy. Dopaminergic agonists seem to be effective for apathy. Acetylcholine esterase inhibitors, methylphenidate, atypical antipsychotics, nicergoline, and cilostazol are another choice. Medication choice should be determined according to the background and underlying etiology of the targeting disease.

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Section: Treatment For Dysthymiamentioning

confidence: 99%

Dysthymia and Apathy: Diagnosis and Treatment

Ishizaki

Mimura

2011

Depression Research and Treatment

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“…In fact, open-label and controlled trials have demonstrated efficacy of a variety of agents, useful for the treatment of major depression, for the treatment of patients with dysthymic disorder. These treatments involve tricyclic antidepressants, monoamine oxidase inhibitors, newer medications such as SSRIs, venlafaxine, mirtazapine, and psychotherapies which have been developed for the treatment of depression such as cognitive behavioral therapy, the Cognitive Behavioral Analysis System of Psychotherapy, and interpersonal psychotherapy [Kocsis et al, 1988Rosenthal et al, 1992;Harrison and Stewart, 1993;Howland, 1991;Keller et al, 1993Keller et al, , 2000Vanelle et al, 1997;Hellerstein et al, 1993Hellerstein et al, , 1999Hellerstein et al, , 2000Ravindran et al, 1994Ravindran et al, , 1998Ravindran et al, , 1999Ravindran et al, , 2000Nobler et al, 1996;Dunner et al, 1996Dunner et al, , 1997Dunner et al, , 1999Dunner, 1996Dunner, , 1998Thase et al, 1996;Markowitz, 1996;McCullough, 1991McCullough, , 2000Ballus et al, 2000;Lima and Moncrieff, 2000;Williams et al, 2000].…”

Section: Discussionmentioning

confidence: 99%

“…The rationale for low-dose treatment was that dysthymia is a "mild" depression and that low doses of antidepressants might suffice. However, it is clear from treating patients with this condition that, although the ratings of dysthymic patients are milder than that seen for patients with major depressive disorder, patients with dysthymic disorder are difficult to treat and, like other forms of chronic depression, require high doses of antidepressants for long periods of time [Kocsis et al, 1988Howland, 1991;Harrison and Stewart, 1993;Rosenthal et al, 1992;Hellerstein et al, 1993Hellerstein et al, , 1999Hellerstein et al, , 2000Ravindran et al, 1994Ravindran et al, , 1998Ravindran et al, , 1999Ravindran et al, , 2000Nobler et al, 1996;Dunner et al, 1996Dunner et al, , 1997Dunner et al, , 1999Dunner, 1996Dunner, , 1998Thase et al, 1996;Ballus et al, 2000;Keller et al, 1993Keller et al, , 2000Lima and Moncrieff, 2000;Vanelle et al, 1997;Williams et al, 2000].…”

Section: Introductionmentioning

confidence: 99%

Dysthymic disorder: Treatment with citalopram

et al. 2002

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We studied 15 patients with dysthymic disorder with open-label citalopram. The purpose of this study was to determine the dose range and safety of citalopram necessary for treatment of patients with dysthymic disorder and to attempt to increase doses in order to enhance remission of patients with dysthymic disorder when treated. Citalopram was well tolerated. The mean dose used in this 10-week study was 37.3 mg and the majority of patients responded to treatment. Various criteria for response and remission were employed. These findings are intended to give guidelines for a subsequent treatment study of dysthymic patients with citalopram using a double-blind placebo-controlled strategy.

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“…Table 1 lists the 6 original trials, study designs, antidepressant agents used, mean doses, and the number of subjects from the no lifetime alcohol use disorder (NLAUD) and lifetime alcohol use disorder (LAUD) groups included in response analyses. At the time of this publication, data from 4 of these trials were published (Hellerstein et al, 1999;Hellerstein, Little, et al, 2001;Hellerstein, Batchelder, Kreditor, & Fedak, 2001;Hellerstein et al, 2004). All trials examined treatment response to pharmacotherapy in outpatients who met the most recent DSM criteria for DD (DSM-III-R or DSM-IV) and received treatment in an outpatient research program in an urban medical center.…”

Section: Generalmentioning

confidence: 99%

Does a History of Alcohol Use Disorder Affect Response to Antidepressant Medication in Patients With Dysthymic Disorder?

Arnaout

Batchelder

Rosenthal

et al. 2008

Journal of Dual Diagnosis

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Background: Research on the relationship between depression and alcohol use disorder in remission has been scarce. The authors examined whether a lifetime history of alcohol use disorder affected response to antidepressant treatment of dysthymic disorder (DD) in adult outpatients. Methods: This is a secondary analysis of data from previous prospective medication trials. Data from 123 subjects with DD were included. Subjects were categorized into 2 groups: (1) no lifetime alcohol use disorder (NLAUD) (n = 99) and (2) lifetime alcohol use disorder (LAUD) (n = 24). None of the subjects met criteria for alcohol use disorder for 6 months prior to intake. Rating scales from baseline and after 8 weeks of pharmacotherapy were collected. Results: After 8 weeks of treatment, the NLAUD and LAUD groups did not differ in rates of response or remission, despite significantly higher baseline Hamilton Depression Rating Scale (HDRS)-24 scores in the LAUD group. We also found a greater decrease in symptoms in the LAUD group, as measured by the HDRS-24. Conclusions: Our preliminary findings suggest that DD in remitted alcoholics is at least as responsive to pharmacotherapy as DD in nonalcoholics and support adequate evaluation and treatment of DD in remitted alcoholic patients.

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Venlafaxine in the Treatment of Dysthymia

Cited by 20 publications

References 0 publications

Dysthymia and Apathy: Diagnosis and Treatment

Dysthymia and Apathy: Diagnosis and Treatment

Dysthymic disorder: Treatment with citalopram

Does a History of Alcohol Use Disorder Affect Response to Antidepressant Medication in Patients With Dysthymic Disorder?

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