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Re: Pharmacological Inteverntions for Dysthymia

Posted by John on May 25, 1999, at 3:09:10

In reply to Re: Pharmacological Inteverntions for Dysthymia, posted by Sean on May 24, 1999, at 17:15:52

> > Are the pharmacological interventions for dysthymia
> > the same as or similar to that for major depression? I
> > can imagine that ECT would not be indicated for dysthymia,
> > whereas it might be life-saving for someone with in a
> > major depressive episode. Analagously, I would not be surprised
> > to learn that some medicines that would be readily used for
> > major depression might not be indicated on a cost/benefit basis
> > for dysthymia, but I have seen little, if anything, in print on
> > the subject.
> > I DID read from David Burns, M.D., that MAO inhibitors might
> > be more efficacious for dysthymia than TCAs or SSRIs used either
> > alone or in combination. I am not aware of any follow-up studies
> > supporting this, though.
> > Any help from the M.D.s out there?
> I'm not a doc, but I've read widely on dysthymia
> after years of personal experience with cyclothymia,
> panic, and depression.
> The best doctor I can refer you to is Hagop Akiskal.
> He has been working on the medication issues around
> dysthymia for many years. It is his opinion that
> dysthymia is physiologicaly related to the bipolar
> disorders and tends to respond better to drugs
> usually reserved for modd stabilization or
> treating the depressed phase of bipolar disorder
> (e.g., Lithium, depakote, MAOI's, etc...) Not
> everyone agrees with this opinion, but certainly
> he has done numerous studies to back up his claims.
> I could ramble on for hours about his work, but
> suffice to say it is very well respected and at the
> cutting edge of nosology (how diseases are classified).
> You can find many of his papers on the net via
> Pubmed.
> Good luck!
> Sean.

I've been fighting dysthymia for years now, with no real help from SSRIs, TCAs, or others like Serzone, Wellbutrin, Remeron. From my own experience I must conclude that therapy will not come from the normal treatment of depression. I must now consider this as I explore MAOIs and/or mood stabilizers. Somewhere is Pharmacology Tips I remember someone commenting that in other countries they treat dysthymia successfully with mood stabilizers, which is a different approach, and apparently better received, than what they do in the USA. John.




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