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 .
Moclobemide and imipramine in chronic depression (dysthymia): an international double‐blind, placebo‐controlled trial
An international , multicenter , placebo-controlled study was undertaken to determine the safety and antidepressant efficacy of moclobemide , a new reversible inhibitor of monoamine oxidase A , and imipramine in the treatment of dysthymia ( DSM-III R ) . A total of 315 patients were enrolled and r and omly assigned to an 8-week treatment in one of three groups ( moclobemide . imipramine and placebo ) . Patients were male or female out patients aged between 18 and 65 years meeting DSM-III-R criteria for dysthymia , primary type , with late or early onset . Of the patients in each group 85 % completed the 8-week treatment period . The percentage of patients who no longer fulfilled DSM-III-R symptom criteria at treatment end-point was significantly higher in the moclobemide ( 60 % ) and imipramine ( 49 % ) treatment groups than in the placebo group ( 22 % ) . Differences to placebo were also statistically significant both for moclobemide and for imipramine on the other efficacy variables ( i.e. Hamilton Rating Scale for Depression , final overall efficacy assessment , Clinical ( Global Impression and symptom check list self rating ) , A significant superiority of moclobemide and imipramine over placebo was found in pure dysthymia and in double-depression , as well as in early and late onset subgroups . In early onset cases , moclobemide was significantly more effective than was imipramine on the Ramilton Rating Scale for Depression . Anticholinergic symptoms and sleepiness were significantly more frequent side effects on imipramine than on moclobemide or on placebo , and the investigators ' final overall assessment of tolerability significantly favoured mociohemide over imipramine . This study demonstrates the efficacy of high dose moclobemide ( mean dose 675mg/day ) and high dose imipramine ( 220 mg/day ) against placebo in the treatment of dysthymia .  Moclobemide was better tolerated than was imipramine
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 .