Psychiatria pre prax 6/2002

Dysthymia and its therapy

Dysthymic disorder affects about 3–5% of adults, which makes it a significant public health problem. Dysthymic patients rarely carried the diagnosis of dysthymia alone; rather, these patients frequently met criteria for several diagnoses. Dysthymie overlap frequently with major depression, anxiety disorders, substance abuse and personality disorders. It can also be comorbid with medical disorders. The reclassification of dysthymic disorder as a mood disorder in DSM-III encouraged the use of antidepressant medication in treatment. Treatment: Tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-2receptor antagonists and monoamine oxidase inhibitors have demonstrated efficacy in the short-term term treatment and prevents relapse and recurrence. Recent controlled studies proved the efficacy of amisupride in the treatment of dysthymic disorder. Amisulpride presented a shorter latency of response comparing with fluoxetine.

Keywords: dysthymia, symptomatology, diagnostic criteria, differential diagnosis, pharmacotherapy.