Intervention Review

Pharmacotherapy for dysthymia

  1. Mauricio Silva de Lima1,*,
  2. Matthew Hotopf2

Editorial Group: Cochrane Depression, Anxiety and Neurosis Group

Published Online: 21 JUL 2003

Assessed as up-to-date: 26 APR 2003

DOI: 10.1002/14651858.CD004047

How to Cite

Silva de Lima M, Hotopf M. Pharmacotherapy for dysthymia. Cochrane Database of Systematic Reviews 2003, Issue 3. Art. No.: CD004047. DOI: 10.1002/14651858.CD004047.

Author Information

  1. 1

    Eli Lilly & Co, Medical, Basingstoke, Hampshire, UK

  2. 2

    The Institute of Psychiatry, Department of Psychological Medicine, London, UK

*Mauricio Silva de Lima, Medical, Eli Lilly & Co, Lilly House, Priestley Road, Basingstoke, Hampshire, RG24 9NL, UK. msilvadelima@yahoo.com.br. limama@lilly.com.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 21 JUL 2003

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Many drug treatments have been proposed for the treatment of dysthymia, but with so many potential comparisons it is not possible at the present time to determine which is the treatment of choice. There is a need to know whether the different classes of antidepressants have similar efficacy. In addition, the tolerability of treatments may be even more important, since dysthymia is a chronic condition characterised by less severe symptoms than major depression.

Objectives

To conduct a systematic review of all randomised controlled trials comparing two or more active drug treatments for dysthymia.

Search methods

Electronic searches of Cochrane Library, EMBASE, MEDLINE, PsycLIT and LILACS, Biological Abstracts; reference searching; personal communication; unpublished trials from pharmaceutical industry.

Selection criteria

Only randomised and quasi-randomised controlled trials were included. Trials had to compare at least two active drug treatments in the treatment of dysthymia. Exclusion criteria were: non-randomised studies, studies which included patients with mixed major depression/dysthymia and studies on depression/dysthymia secondary to other disorders (e.g. substance abuse).

Data collection and analysis

The reviewers extracted the data independently and odds ratios, weighted mean difference and number needed to treat were estimated. The reviewers assumed that people who died or dropped out had no improvement and tested the sensitivity of the final results to this assumption.

Main results

A total of 14 trials were eligible for inclusion in the review. All studied drugs promoted similar clinical responses, although with different side effect profiles. The evidence for TCAs and SSRIs was the most robust, considering the number of trials and participants.

Authors' conclusions

The conclusion is that the choice of drug must be made based on consideration of drug-specific side effect properties.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Drug treatments for dysthymia

Many drug treatments have been proposed for the treatment of dysthymia. There is a need to know whether the different classes of antidepressants have similar efficacy. The tolerability of treatments may be even more important, since dysthymia is a chronic condition characterised by less severe symptoms than major depression. A total of 14 trials were included in this review. All drugs promoted similar clinical responses, although with different side effect profiles. There are no significances differences in efficacy between different classes of antidepressants in the treatment of dysthymia, although side effect profiles may be different. The evidence for TCAs and SSRIs was the most robust. The conclusion is that the choice of drug must be made based on consideration of drug-specific side effect properties.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

輕鬱症之藥物治療

許多藥物被用來治療輕鬱症,但在許多治療可能性的比較裡,目前未能確定那些是治療選項.我們需要去了解不同種類的抗憂鬱劑是否有相同的效果.除此之外,既然輕鬱症是比重鬱症症狀輕微的一種慢性精神狀態,治療的忍受性可能更加重要.

目標

對所有比較2項或更多現行治療輕鬱症藥物的隨機對照試驗進行系統性回顧.

搜尋策略

電子搜尋資料庫包括Cochrane Library, EMBASE, MEDLINE, PsycLIT and LILACS, Biological Abstracts;並搜尋參考資料,個人通訊,及藥商未發表之試驗.

選擇標準

只有納入隨機及半隨機對照試驗.試驗必須比較至少兩個治療輕鬱症的現行藥物.排除條款為:非隨機對照試驗,若該試驗也包含了混合重鬱/輕鬱患者且該研究針對次發於其他疾患之憂鬱/輕鬱(例如,物質濫用).

資料收集與分析

資料回顧者獨立地解讀數據,並計算odds ratios, weighted mean difference and number needed to treat.資料回顧者假定死亡或退出者為症狀沒有改善,並測試在此假定下試驗最終結果的敏感度.

主要結論

共有14個試驗被選入此回顧試驗.所有研究藥物具有類似的臨床反應.考量試驗及參與者數目, TCAs和SSRI的證據力最為堅固.

作者結論

結論是必須根據藥物特定的副作用特性來做藥物的選擇.

翻譯人

本摘要由彰化基督教醫院張庭綱翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

治療輕鬱症的抗憂鬱劑儘管不同的副作用特性,不同種類抗憂鬱劑在藥效上並未有明顯差異.許多藥物正被計畫用來治療輕鬱症.我們需要去了解不同種類的抗憂鬱劑是否有相同的效果.除此之外,既然輕鬱症是比重鬱症症狀輕微的一種慢性精神狀態,治療的忍受性可能更加重要.共有14個試驗被選入此回顧試驗.所有研究藥物具有類似的臨床反應.考量試驗及參與者數目, TCAs和SSRI的證據力最為堅固.結論是必須根據藥物特定的副作用特性來做藥物的選擇.