THERAPEUTIC EFFICACY OF SPECIFIC SEROTONIN REUPTAKE INHIBITORS (SSRIS) IN DYSTHYMIA

Pharmacological treatment of dysthymia is a contentious issue mainly b ecause of the traditional view that this disorder has characterologica l origins and responds to psychotherapy. However, Akiskal's subtyping of primary dysthymia, which was based in part on its response to older antidepressants, can assist in the prediction of responses to antidep ressants. Specific serotonin reuptake inhibitors (SSRIs) have equal ef ficacy but fewer adverse effects and greater tolerability than older a ntidepressants. Therefore, SSRIs appear to be a viable treatment optio n for these patients although there are few documented systematic stud ies of the use of these agents in primary dysthymia. An open study was conducted to determine the efficacy of fluoxetine in primary dysthymi a (DSM-III-R and Akiskal's criteria). A good response was observed in the subaffective subtype but not in the character spectrum group. Over all, the antidepressant was tolerated well, with significant adverse e ffects reported and responders showing reductions in both depressive a nd anxious symptoms. These initial findings indicate a potential role for SSRIs in the pharmacotherapy of dysthymia.