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 .
The treatment of chronic depression, part 1: study design and rationale for evaluating the comparative efficacy of sertraline and imipramine as acute, crossover, continuation, and maintenance phase therapies.
BACKGROUND Chronic depressions are common , disabling , and undertreated , and prior chronicity predicts future chronicity . However , few studies directly inform the acute or maintenance phase treatments of chronic depressions and even less is known about the effects of treatment on psychosocial functioning . METHOD We describe the design and rationale for 2 parallel double-blind , r and omized , multicenter acute and maintenance phase treatment trials . One focused on DSM-III-R major depression currently in a chronic ( > or = 2 years ) major depressive episode , the other on DSM-III-R major depression with concurrent DSM-III-R dysthymia ( " double depression " ) . RESULTS Considering the critical knowledge deficits , we design ed a 12-week acute phase safety and efficacy trial of sertraline versus imipramine , followed by a 16-week continuation treatment phase for subjects with a satisfactory therapeutic response . Patients receiving sertraline who successfully completed the continuation phase entered a 76-week maintenance trial to compare sertraline with placebo ; those taking imipramine continued without a placebo substitution . As part of the acute trial , subjects completing but failing to respond to the initial 12-week acute phase medication were crossed over ( double-blind ) to the alternative medication for a 12-week acute phase trial . We obtained naturalistic follow-up data ( up to 18 months ) for subjects exiting the protocol at any time . CONCLUSION Multiphase protocol s for chronic depression can test efficacy by r and omized contrasts as well as shed light on key clinical issues such as the degree of response or attrition expected at particular times in a trial or the preferred medication sequence in a potential multistep treatment program
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 .