Clinical Question Which mix with ...

Clinical Question

Which mix with drugs treatments for dysthymia are most numerous effective?

Evidence-Based Answer

All antidepressants studied have similar efficacy in the treatment of patients with dys-thymia. Side meaning profiles vary. The largest comparisons support the use of tricyclic anti-depressants and selective serotonin reuptake inhibitors (SSRIs).

Practice Pointers

Patients with dysthymia have les harsh but more chronic symptoms than patients with depression. De Lima and colleagues published sum of two units systematic reviews (1,2) on the treatment of dysthymia. The first review, from De Lima and Moncrieff, (1) raise that anti-depressants are highly effective in treating dysthymia compared with placebo. Approximately four patients must be treated to achieve common response. However, it is not clear which antidepressant furnishs the best results.

To determine the most numerous effective antidepressant, De Lima and Hotopf (2) searched for randomized and quasi-randomized controll trials comparing at least sum of two units active drug treatments. Patients in these studies had dysthymia for at least pair years and were studied for four to 12 weeks in psychiatric, primary care, and community settings.

Tricyclic antidepressants, SSRIs and mono-amine oxidase inhibitors had similar efficacy. Imipramine was the chiefly commonly studied tricyclic antidepressant, and fluoxetine was the chiefly commonly studied SSRI. Only individual study compared SSRIs with tricyclic anti-depressants. one as well as the other drug classes had a similar general intent on mood, but the SSRIs had a lower dropout rate. Therefore, medication choice should be based forward the side effect profile. No data are available in succession optimal dosage or length of treatment.

REFERENCES

(1) De Lima M Moncrieff J remedys versus placebo for dysthymia. Cochrane Database Syst Rev 2000;4:CD001130

(2) De Lima M Hotopf M A comparison of active physics for the treatment of dysthymia. Cochrane Database Syst Rev 2003;3:CD00404

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group