Dysthymia - Review - New Findings - Treatment Guindelines

ABSTRACT

Open trials with tricyclics, classical MAOIs or Lithium in dysthymia yielded a response rate in 45 per cent of subjects. A liong-term treatment of dysthymia with 276 patients treated during four years with eithermoclobemide,tranylcypromine or a combination of amitryptiline plus chlordiazepoxide is described. After discontinuation there was a relapse rate of 89.1 per cent. The controlled studies with tricycles, classical MAOIs, RIMAs, SSRs or benzamides showed that drugs well tolerated work better in dyathymia, due to the fact that the treatment has to be long-term. Sertraline was studied versus placebo or imipramine in primary dysthymia. Moclobemide, imipramine and polacebo were also studied in 315 patients. Mean doses were 650.0 mg-day of moclobemide, 203.2 mg-day of imipramine. Moclobemide and sertraline were both efficacious and well tolerated. In a long term treatment the clinician should assess the risk-benefit ratio. Dysthymic patients are very sensitive to unwanted effects and compliance is a serious issue