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Pharmacotherapy of dysthymia: review and new findings

Published online by Cambridge University Press:  16 April 2020

M Versiani ,
AE Nardi  and
I Figueira
M Versiani*
Affiliation:
Institutional Affiliation, Institute of Psychiatry, Federal University of Rio de Janeiro, Anxiety and Depression Research Program, Rio de Janeiro, Brazil
AE Nardi
Affiliation:
Institutional Affiliation, Institute of Psychiatry, Federal University of Rio de Janeiro, Anxiety and Depression Research Program, Rio de Janeiro, Brazil
I Figueira
Affiliation:
Institutional Affiliation, Institute of Psychiatry, Federal University of Rio de Janeiro, Anxiety and Depression Research Program, Rio de Janeiro, Brazil
*
*Address for correspondence and reprints: Rua Visconde de Pirajá 407 sala 805, Ipanema, Rio de Janeiro - RJ, Brazil, CEP - 22410-003.
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Summary

Open trials with tricyclics, classical monoamine oxidase inhibitors (MAOIs) or lithium in dysthymia yielded a response rate in 45% of subjects. A long-term treatment of dysthymia with 276 patients treated during 4 years with either moclobemide, tranylcypromine or a combination of amitryptiline plus chlordiazepoxide is described. After discontinuation there was a relapse rate of 89.1%. The controlled studies with tricyclics, MAOIs, reversible inhibitors of monoamine oxidase (RIMAs), specific serotonin reuptake inhibitor (SSRIs) or benzamides showed that drugs well-tolerated work better in dysthymia, due to the fact that the treatment must be long-term. Sertraline was studied vs placebo or imipramine in primary dysthymia. Moclobemide, imipramine and placebo were also studied in 315 patients. Mean doses were 650 mg/d of moclobemide and 203.2 mg/d 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.

Keywords

dysthymiadysthymic disorderdrug treatment
Type
Research Article
Information
European Psychiatry , Volume 13 , Issue 4 , July 1998 , pp. 203 - 209
Copyright
Copyright © Elsevier, Paris 1998

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