Korean J Biol Psychiatry.  2007 Feb;14(1):14-20.

Pharmacological Treatments for Dysthymic Disorder and Atypical Depression

Affiliations
  • 1Department of Psychiatry, Kangbuk Samsung Hospital, Sung-kyunkwan University School of Medicine, Seoul, Korea. ks2485@empal.com

Abstract


OBJECTIVES
The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression.
METHODS
Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. RESULT: For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors(SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants.
CONCLUSION
The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

Keyword

Dysthymic disorder; Atypical depression; Antidepressant; Evidence-based medicine

MeSH Terms

Antidepressive Agents
Antidepressive Agents, Tricyclic
Depression*
Diagnosis
Diagnostic and Statistical Manual of Mental Disorders
Dysthymic Disorder*
Evidence-Based Medicine
Humans
Moclobemide
Serotonin
Antidepressive Agents
Antidepressive Agents, Tricyclic
Moclobemide
Serotonin
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