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What is dysthymia?
Dysthymia is a type of low-grade depression. It is considered a chronic depression, a long-lasting illness, but with less severity than major depressive disorder. People with dysthymia generally experience little or no joy in their lives. Because dysthymia may develop early in a person's life, it is not uncommon for someone with this condition to believe that it is normal to always feel depressed. When a person finally seeks treatment for dysthymia, it is not uncommon that he/she has had this condition for a number of years. This is unfortunate since the sooner a person seeks help the sooner he or she can get relief and possibly avoid further distress. It is very important that children with symptoms of dysthymia receive an evaluation from a mental health professional or physician. Early treatment may help these youngsters avoid more serious mood disorders, difficulties in school and their social life, and possible substance abuse problems as they get older.
Clinical trial background
Despite the high prevalence of dysthymia and its associated morbidity, few controlled trials have evaluated the efficacy of antidepressant medication for this disorder. A 12-week, double-blind, placebo-controlled, randomized, multicenter trial was performed to evaluate the safety and efficacy of sertraline hydrochloride and imipramine hydrochloride in treating dysthymia.
Methods
A total of 416 outpatients (271 women and 145 men) aged 25 to 65 years with DSM-III-R-difined, early-onset, primary dysthymia without concurrent major depression were randomized to 12 weeks of treatment with sertraline, imipramine, or placebo.
Results
Both active treatments resulted in significantly reduced scores on the 17-item Hamilton Rating Scale for Depression (P=.04 and P=.01 for sertraline and imipramine vs placebo, respectively), the Montgomery Asberg Depression Rating Scale (P=.01 and P=.003 vs pIacebo, respectively), Hopkins Symptom Checklist (P<.05 and the self-rated version of inventory depressive symptoms with use a clinical global impressions improvement score or much improved to define response rates were for sertraline imipramine piacebo vs placebo p significantly greater proportion patients receiving than those discontinued treatment because adverse events respectively>
Conclusions
Pharmacotherapy provides considerable relief from the symptoms of dysthymia in patients suffering from this chronic affective disorder, with both sertraline and imipramine being more effective than pIacebo. The greater tolerability of sertraline is an important consideration because of the chronicity of dysthymia, which may require prolonged treatment with antidepressant medication.
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