Korean Journal of Biological Psychiatry (생물정신의학)
- Volume 14 Issue 1
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- Pages.14-20
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- 2007
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- 1225-8709(pISSN)
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- 2005-7571(eISSN)
Pharmacological Treatments for Dysthymic Disorder and Atypical Depression
기분부전장애와 비전형우울증의 약물치료
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Lim, Se-Won
(Department of Psychiatry, Kangbuk Samsung Hospital, Sung-kyunkwan University School of Medicine) ;
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Oh, Kang-Seob
(Department of Psychiatry, Kangbuk Samsung Hospital, Sung-kyunkwan University School of Medicine)
- Published : 2007.02.28
Abstract
Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.
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