Psychopharmacological treatment response of patients with a DSM-III diagnosis of dysthymic disorder.

In spite of its significant morbidity, dysthymic disorder has been under-researched, therefore effective treatment options are limited. This article presents data suggesting that dysthymia can be treated effectively with psychopharmacologic agents. A double-blind, placebo-controlled 7-week drug trial comparing imipramine to ritanserin, a serontonin-2 antagonist, indicated that both drugs were significantly more effective than placebo in alleviating dysthymia symptoms. Imipramine was slightly more effective than ritanserin, as indicated by ratings on the Hamilton Depression Rating Scale and the Zerssen Self-Rating Scale; however, imipramine also produced more side effects. On the basis of this study, we continued an open protocol for treating dysthymic patients with a specific serotonin reuptake inhibitor, fluoxetine. This open-label study indicated that fluoxetine was successful in reducing the dysthymia symptoms, particularly in the subaffective sub-type. These studies confirm the need for further research into the treatment options for patients suffering from dysthymia.