PMID- 11034701
OWN - NLM
STAT- MEDLINE
DCOM- 20010802
LR  - 20181130
IS  - 1469-493X (Electronic)
IS  - 1361-6137 (Linking)
IP  - 4
DP  - 2000
TI  - Drugs versus placebo for dysthymia.
PG  - CD001130
AB  - OBJECTIVES: Dysthymia is a depressive disorder of chronic nature but of less 
      severity than major depression, which depressive symptoms are more or less 
      continuous for at least two years. The aim of this review was to conduct a 
      systematic review of all RCTs comparing drugs and placebo for dysthymia. SEARCH 
      STRATEGY: Electronic searches of Cochrane Library, EMBASE, MEDLINE, PsycLIT, 
      Biological Abstracts and LILACS; reference searching; personal communication; 
      conference abstracts; unpublished trials from the pharmaceutical industry; book 
      chapters on the treatment of depression. SELECTION CRITERIA: The inclusion 
      criteria for all randomised controlled trials were that they should focus on the 
      use of drugs versus placebo for dysthymic patients. Exclusion criteria were: non 
      randomised, mixed major depression/ dysthymia (trials not providing separate 
      data) and depression secondary to other disorders (e.g. substance abuse). DATA 
      COLLECTION AND ANALYSIS: The reviewers extracted the data independently. In order 
      to achieve an intention-to-treat analysis, when trials failed to report it was 
      assumed that people who died or dropped out had no improvement. Authors of 
      relevant trials were contacted for additional and missing data. Absence of 
      treatment response as defined by authors was the main measure of outcome used. 
      Relative Risks (RR) and 95% confidence intervals (CI) of dichotomous data were 
      calculated with the Random Effects Model. Where possible, number needed to treat 
      (NNT) and number needed to harm (NNH) were estimated, taking the reciprocal of 
      the absolute risk reduction. MAIN RESULTS: Currently the review includes 15 
      trials. Similar results were obtained in terms of efficacy for different groups 
      of drugs, such as tricyclic (TCA), selective serotonin reuptake inhibitors 
      (SSRI), monoamine oxidase inhibitors (MAOI) and other drugs (sulpiride, 
      amineptine, and ritanserin). The pooled RR for absence of treatment response was 
      0.68 (95% CI 0.59-0.78) for TCA and the NNT was 4.3 (95% CI 3.2-6.5). SSRIs 
      showed similar RR for this outcome: 0.64 (95% CI 0.55-0.74), the NNT being 4.7 
      (95% CI 3.5-6.9). Concerning MAOIs, the RR was 0.59 (95% CI 0.48-0.71) and the 
      NNT was 2.9 (95% CI 2.2-4.3). Other drugs (amisulpride, amineptine and 
      ritanserin) showed similar results in terms of absence of treatment response. 
      Using more stringent criteria for improvement - full remission - the results were 
      unchanged. Patients treated on TCA were more likely to report adverse events, 
      compared with placebo. REVIEWER'S CONCLUSIONS: Drugs are effective in the 
      treatment of dysthymia with no differences between and within class of drugs. 
      Tricyclic antidepressants are more likely to cause adverse events and dropouts. 
      As dysthymia is a chronic condition, there remains little information on quality 
      of life and medium or long-term outcome.
FAU - Lima, M S
AU  - Lima MS
AD  - Department of Mental Health, Universidade Federal de Pelotas, Avenida Duque de 
      Caxias, 250, Pelotas, Rio Grande do Sul, BRAZIL, 96100. mslima@nutecnet.com.br
FAU - Moncrieff, J
AU  - Moncrieff J
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - England
TA  - Cochrane Database Syst Rev
JT  - The Cochrane database of systematic reviews
JID - 100909747
RN  - 0 (Antidepressive Agents)
RN  - 0 (Placebos)
SB  - IM
UOF - Cochrane Database Syst Rev. 2000;(2):CD001130. PMID: 10796749
UIN - Cochrane Database Syst Rev. 2015;6:CD001130. PMID: 26087170
MH  - Antidepressive Agents/*therapeutic use
MH  - Dysthymic Disorder/*drug therapy
MH  - Humans
MH  - Placebos
MH  - Randomized Controlled Trials as Topic
RF  - 128
EDAT- 2000/10/18 11:00
MHDA- 2001/08/03 10:01
CRDT- 2000/10/18 11:00
PHST- 2000/10/18 11:00 [pubmed]
PHST- 2001/08/03 10:01 [medline]
PHST- 2000/10/18 11:00 [entrez]
AID - CD001130 [pii]
AID - 10.1002/14651858.CD001130 [doi]
PST - ppublish
SO  - Cochrane Database Syst Rev. 2000;(4):CD001130. doi: 10.1002/14651858.CD001130.