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 .
Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years.
OBJECTIVE The research ers evaluated the effectiveness of paroxetine and Problem-Solving Treatment for Primary Care ( PST-PC ) for patients with minor depression or dysthymia . STUDY DESIGN This was an 11-week r and omized placebo-controlled trial conducted in primary care practice s in 2 communities ( Lebanon , NH , and Seattle , Wash ) .  Paroxetine ( n=80 ) or placebo ( n=81 ) therapy was started at 10 mg per day and increased to a maximum 40 mg per day , or PST-PC was provided ( n=80 ) . There were 6 scheduled visits for all treatment conditions . POPULATION A total of 241 primary care patients with minor depression ( n=114 ) or dysthymia ( n=127 ) were included . Of these , 191 patients ( 79.3 % ) completed all treatment visits . OUTCOMES Depressive symptoms were measured using the 20-item Hopkins Depression Scale ( HSCL-D-20 ) . Remission was scored on the Hamilton Depression Rating Scale ( HDRS ) as less than or equal to 6 at 11 weeks . Functional status was measured with the physical health component ( PHC ) and mental health component ( MHC ) of the 36-item Medical Outcomes Study Short Form . RESULTS All treatment conditions showed a significant decline in depressive symptoms over the 11-week period . There were no significant differences between the interventions or by diagnosis . For dysthymia the remission rate for paroxetine ( 80 % ) and PST-PC ( 57 % ) was significantly higher than for placebo ( 44 % , P=.008 ) . The remission rate was high for minor depression ( 64 % ) and similar for each treatment group . For the MHC there were significant outcome differences related to baseline level for paroxetine compared with placebo . For the PHC there were no significant differences between the treatment groups . CONCLUSIONS For dysthymia , paroxetine and PST-PC improved remission compared with placebo plus nonspecific clinical management . Results varied for the other outcomes measured . For minor depression , the 3 interventions were equally effective ; general clinical management ( watchful waiting ) is an appropriate treatment option
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 .