ABSTRACT
By contrast with major depression, dysthymic disorder (dysthymia) is characterized by the combination of chronicity and milder depressive symptoms. Because of its typically early age of onset, chronic course, mild symptoms, and association with longstanding psychosocial and personality problems, psychotherapy historically was viewed as the most appropriate treatment approach [1,2]. This common perception contributed to a paucity of empirical data on the utility of antidepressant drugs in the treatment of dysthymia until the 1980s when the concept of dysthymia as a mood disorder began to evolve and pharmacotherapy studies began to appear in the literature [3,4]. This chapter reviews the psychopharmacology of dysthymia, emphasizing the results of randomized controlled clinical trials of heterocyclic antidepressants, monoamine oxidase inhibitors (MAOIs), serotonin reuptake inhibitors (SRIs), atypical antidepressant drugs, and atypical antipsychotic drugs. Because of their similarities to dysthymia, recent treatment studies of chronic major depression and double depression (i.e., major depression superimposed on dysthymia) will
also be reviewed. In addition, long-term treatment studies of dysthymia and other chronic depressions will be reviewed. Finally, some important methodological issues, areas for further study, and general clinical principles for treating dysthymia will be discussed.
