Medication for Dysthymia

Jerry Kennard Health Pro

    Dysthymia is often thought of as a mild form of depression. In reality it is a chronic mood disorder that can become a form of life-long depression. Dysthymia in adults lasts for at least two years.


    For most days, and for most of the day, the symptoms of dysthymia persist. Energy levels are low and even the most minor activity can feel fatiguing. It's difficult to concentrate and sometimes decision making over the simplest choices is hard, for example, ‘tea or coffee?' The sense of hopelessness can feel grinding. Despite feeling tired and exhausted it can be difficult getting to sleep or staying asleep.

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    The most commonly prescribed medications for dysthymia fall into the selective serotonin reuptake inhibitor (SSRI) category. These are Celexa, Lexapro, Luvox, Paxil, Prozac, and Zoloft. Compared with placebo trials these drugs have a moderately positive effect. All antidepressants in this class take a few weeks to reach their full potential, but it should be noted that antidepressants for dysthymia do not work as effectively as for major depression.


    So-called first generation antidepressants are still available and still prescribed. These tricyclic antidepressants as they are known include Adapin, Anafranil, Asendin, Elavil, Sinequan and Tofranil. The action of these antidepressants is different to those of SSRIs but appear to have better effects in some people. The most marked difference between first and second generation antidepressants related to side effects. Typically, first generation antidepressants are associated with sedative (sleepy) effects and a dry, of metallic-tasting, mouth.


    The usual course is for doctors to prescribe SSRI medication in the first instance. If these have no effect they may suggest trying first generation medication instead. Although medication may not have the desired effect of relieving the symptoms of dysthymia there is a case for combining this with an additional treatment such as cognitive behavioral therapy. This combination of treatments may help to relieve symptoms entirely or take the edge off the worst symptoms. Either way, ignoring dysthymia in the hope that symptoms may be relieved in time could backfire and lead to a situation where symptoms worsen and develop into a major depressive episode.

Published On: May 25, 2011