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 with sertraline: a double-blind, placebo-controlled trial in dysthymic patients without major depression.
BACKGROUND The selective serotonin reuptake inhibitor sertraline has been shown to be efficacious and well tolerated for the treatment of major depressive disorder . Relatively few trials , however , have examined the role of pharmacotherapy in dysthymia without concurrent major depression . The current investigation focuses on the use of sertraline for the treatment of dysthymia . METHOD In this 12-week , multicenter , double-blind study , 310 patients with a DSM-III-R diagnosis of dysthymic disorder without concurrent major depression were r and omly assigned to receive either sertraline ( N = 158 ) or placebo ( N = 152 ) .  Sertraline was initiated at a dose of 50 mg daily , with titration permitted to a maximum of 200 mg daily . The primary evaluation criteria were the Structured Interview Guide for the Hamilton Depression Rating Scale , Seasonal Affective Disorder Version ( SIGH-SAD ) , the Montgomery-Asberg Depression Rating Scale ( MADRS ) , and the Clinical Global Impressions-Severity of Illness ( CGI-S ) and -Improvement ( CGI-I ) scales . RESULTS Mean percentage reductions for the intent-to-treat population in SIGH-SAD scores were 44.6 % for the sertraline-treated group and 33.2 % for the placebo-treated group ( p = .03 ) ; MADRS scores , 43.6 % and 33.0 % ( p = .02 ) ; and CGI-S scores , 32.8 % and 22.8 % ( p = .02 ) . A significantly greater proportion of the sertraline-treated group was classified as responders ( defined for HAM-D and MADRS scores as a 50 % score reduction and for CGI-I as a score of 1 or 2 by the final visit ) and remitters ( SIGH-SAD score < or = 8) relative to the placebo-treated group by the final visit . In addition , sertraline-treated patients experienced greater improvements in all 9 domains of the Battelle Quality of Life Question naire than placebo-treated patients did , with a significant difference observed in favor of sertraline in 8 of the 9 domains . The life satisfaction and social interaction quality of life domains showed significantly greater response in sertraline responders compared with placebo SIGH-SAD responders . Sertraline was well tolerated . Thirteen percent of the sertraline-treated group versus 8 % of the placebo-treated group withdrew from therapy owing to adverse events ( p = .14 ) . CONCLUSION Sertraline is efficacious and well tolerated in the short-term treatment of dysthymia without concurrent major depression
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 .