Atypical depression: retrospective self-reporting of treatment effectiveness


Professor Gordon Parker, Black Dog Institute, Prince of Wales Hospital, Randwick 2031, Sydney, Australia.


Objective:  Earlier studies demonstrated that those with atypical depression show a differentially superior response to monoamine oxidase inhibitor (MAOI) antidepressants. This study compares ratings of effectiveness for a range of treatments, amongst depressed subjects with and without atypical features.

Method:  In an on-line survey, individuals experiencing likely clinical depression rated symptoms experienced when depressed, including ‘atypical features’ and the effectiveness of previous treatments. Mean treatment effectiveness ratings were compared amongst those with ‘atypical depression’ (n = 338) and ‘non-atypical depression’ (n = 377).

Results:  There were few significant differences between the ‘atypical depression’ and ‘non-atypical depression’ groups in effectiveness ratings for drug treatments, and none for psychological treatments. The ‘atypical depression’ group had significantly lower mean effectiveness ratings for some selective serotonin reuptake inhibitor antidepressants. Few respondents had trialed MAOIs.

Conclusion:  While MAOIs are rarely prescribed, a range of non-MAOI drug and psychological treatments are of some perceived benefit for depressed patients with atypical features.