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Current pharmacotherapeutic approaches for dysthymic disorder and persistent depressive disorder
Published in Expert Opinion on Pharmacotherapy, 2019
Mauro Giovanni Carta, Pasquale Paribello, Antonio Egidio Nardi, Antonio Preti
A 2009 Cochrane review on the efficacy of second-generation antipsychotics in depression and dysthymia management [76], endorses the use of low-dose amisulpride (i.e. around 50 mg/die) in dysthymia, as it presents an efficacy comparable to that of antidepressants. The most significant side effects reported include prolactin increase in studies comparing amisulpride to placebo, and weight gain in studies comparing the former to antidepressants. The studies included in the analysis compared amisulpride to different antidepressants including imipramine [77], fluoxetine [78], amitriptyline [79], amineptine [80], sertraline [81]. In a previously cited metanalysis [26], amisulpride appeared superior to fluoxetine and presented a lower drop rate as compared with imipramine. In a 2016 systematic review [70], Meister et al. confirmed the efficacy of amisulpride in PDD, and as previously reported found an increased risk for prolactin elevation, weight gain and loss of libido among the most common complaints.