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 .
Controlled efficacy study of fluoxetine in dysthymia.
BACKGROUND There have been very few controlled studies of antidepressants in dysthymia , particularly in sample s diagnosed reliably and with an adequate length of follow-up . In this investigation , we measured the long-term outcome in a large group of patients meeting DSM-III-R criteria for dysthymia . This study was design ed to investigate whether fluoxetine is effective in the treatment of dysthymia . METHOD This r and omised study including 140 patients , compared  fluoxetine ( 91 patients ) and placebo ( 49 patients ) on a double-blind basis in two distinct phases : a short-term end-point ( 3 months with 20 mg/day fluoxetine ) and a medium-term end-point ( 6 months ) where the initial responders continued double-blind treatment unchanged and non-responders received an additional treatment of 20 mg/day fluoxetine . RESULTS After three months of treatment , response was seen more frequently in the fluoxetine group ( 42/72 ) than in the placebo group ( 14/39 , P < 0.0001 ) . Improved patients at 3 months were still improved at 6 months . Furthermore , 50 % of the nonresponders at 3 months improved and rated as responders at 6 months , after fluoxetine was increased to 40 mg daily . CONCLUSIONS This study showed the significant and persistent action of fluoxetine on dysthymia . The finding that 50 % of the non-responders at 3 months were improved at 6 months , after fluoxetine dosage was increased to 40 mg daily , argues in favour of treating dysthymic patients for at least 6 months , and with a higher dosage if the initial doses are ineffective
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 .