CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .
A placebo-controlled, randomized clinical trial comparing sertraline and imipramine for the treatment of dysthymia.
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 , r and omized , multicenter trial was performed to evaluate the safety and efficacy of sertraline hydrochloride and imipramine hydrochloride in treating dysthymia . METHODS A total of 416 out patients ( 271 women and 145 men ) aged 25 to 65 years with DSM-III-R-defined , early-onset , primary dysthymia without concurrent major depression were r and omized to 12 weeks of treatment with  sertraline , imipramine , or placebo . RESULTS Both active treatments result ed 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 placebo , respectively ) , Hopkins Symptom Checklist ( P < .05 ) , and the self-rated version of the Inventory of Depressive Symptoms ( P < .05 ) . With the use of a Clinical Global impressions improvement score of 1 or 2 ( very much or much improved ) to define response , response rates were 59 % for sertraline , 64 % for imipramine , and 44 % for placebo ( P = .02 for sertraline vs placebo and P < .001 for imipramine vs placebo ) . A significantly greater proportion of patients receiving imipramine than those receiving sertraline or placebo discontinued treatment because of adverse events ( P = .001 and P < .001 , 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 placebo . The greater tolerability of sertraline is an important consideration because of the chronicity of dysthymia , which may require prolonged treatment with antidepressant medication
CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .