CoChat
Sign Up
Cited by 25Treatment of Major DepressionMental Health Treatment and AccessPsychological Treatments and Disorders

Benefits and Risks of Pharmacotherapy for Dysthymia: A Systematic Appraisal of the Evidence

De Lima, Maur??cio S., Hotopf, Matthew·2003·Drug Safety
DOI 10.2165/00002018-200326010-00006
Open this paper in CoChat — free account

Abstract

Background Dysthymia is a prevalent form of subthreshold depressive disorder, associated with considerable disability and high co-morbidity. This paper systematically appraises the evidence for the efficacy and acceptability of the pharmacological treatment for this condition.Methods Randomised, controlled trials evaluating the efficacy of drug therapies for dysthymia were included. A comprehensive search of the literature was performed, aiming to avoid publication bias. Pooled relative risks (RR) and 95% CIs were calculated with the Random Effect Model method. The number needed to treat (NNT) and number needed to harm (NNH) were estimated for statistically significant results.Results Twenty-five trials were included for the main comparisons. Regarding placebo-controlled trials (n = 16), similar results were obtained in terms of efficacy for different groups of drugs, such as tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs) and other drugs (sulpiride, amineptine, and ritanserin). The pooled RR for treatment response was 0.68 (95% CI 0.57-0.81) for TCA and the NNT was 4.3 (95% CI 3.2-6.5); 0.68 (95% CI 0.56-0.82) for SSRIs (NNT 5.1; 95% CI 3.9-7.7); 0.59 (95% CI 0.48-0.71) for MAOIs (NNT 2.9; 95% CI 2.2-4.3). Other drugs (amisulpride, amineptine and ritanserin) showed similar results. The equivalent efficacy between antidepressants as found in trials where active medications were compared confirmed the efficacy findings from placebo trials. In general, patients treated with a TCA were more likely to report adverse events, compared with placebo and SSRIs.Conclusions Pharmacotherapy for dysthymia appears to be an effective short-term treatment for dysthymic disorder. Newer antidepressants are equally effective and have better acceptability than TCAs, although their higher cost must be balanced against this assumed advantage.

Integrity signals

Registry

Crossref · 10.2165/00002018-200326010-00006

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Cites

Flagged first, then by citations

2 of the 42 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
De Lima, M. S., & Hotopf, M.
Affiliations
King's College London (GB)
ORCID
Hotopf, Matthew
Venue
Drug Safety
Publisher
Springer Science and Business Media LLC
Published
2003
Volume
26
Issue
1
Pages
55-64
ISSN
0114-5916 (ISSN-L)
DOI
10.2165/00002018-200326010-00006
OpenAlex
W1990370174
Cited by
25
References
42
Citations by year
2022: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2013: 1 · 2012: 1
FWCI
0.85
Type
journal article
Language
en
Open access
closed
Locations
  • Drug Safety (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Disorders
Keywords
dysthymia, pharmacotherapy, antidepressants, tricyclic antidepressants, selective serotonin reuptake inhibitors, monoamine oxidase inhibitors, treatment efficacy, adverse drug reactions, treatment acceptability, number needed to harm, number needed to treat, subthreshold depression
MeSH terms
Antidepressive Agents, Antidepressive Agents, Tricyclic, Dibenzocycloheptenes, Humans, Monoamine Oxidase Inhibitors, Sulpiride, Randomized Controlled Trials as Topic, Ritanserin, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Risk Assessment, Dysthymic Disorder

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review