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Controlled efficacy study of fluoxetine in dysthymia

Published online by Cambridge University Press:  03 January 2018

Jean-Marie Vanelle ,
Dominique Attar-Levy ,
Marie-France Poirier ,
Myriam Bouhassira ,
Patrick Blin  and
Jean-Pierre Olié
Jean-Marie Vanelle*
Affiliation:
Centre Hospitalier Sainte Anne, Paris
Dominique Attar-Levy
Affiliation:
Centre Hospitalier Sainte Anne, Paris
Marie-France Poirier
Affiliation:
Centre Hospitalier Sainte Anne, Paris
Myriam Bouhassira
Affiliation:
Lilly-France, Saint-Cloud, France
Patrick Blin
Affiliation:
Eval, Paris
Jean-Pierre Olié
Affiliation:
Centre Hospitalier Sainte Anne, Paris, France
*
Dr Jean-Marie Vanelle, Service Hospitalo-Universitaire de Santé Mentale et de Thérapeutique, Centre Hospitalier Sainte Anne, I Rue Cabanis, 75014 Paris, France
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Abstract

Background

There have been very few controlled studies of antidepressants in dysthymia, particularly in samples diagnosed reliably and with an adequate length of follow-up. In this investigation, we measured the long-term outcome in a large group of patients meeting DSM – III -R criteria for dysthymia. This study was designed to investigate whether fluoxetine is effective in the treatment of dysthymia.

Method

This randomised study, including 140 patients, compared fluoxetine (91 patients) and placebo (49 patients) on a double-blind basis in two distinct phases: a short-term end-point (3 months with 20 mg/day fluoxetine) and a medium-term end-point (6 months) where the initial responders continued double-blind treatment unchanged and non-responders received an additional treatment of 20 mg/day fluoxetine.

Results

After three months of treatment, response was seen more frequently in the fluoxetine group (42/72) than in the placebo group (14/39, P <0.0001). Improved patients at 3 months were still improved at 6 months. Furthermore, 50% of the non-responders at 3 months improved and rated as responders at 6 months, after fluoxetine was increased to 40 mg daily.

Conclusions

This study showed the significant and persistent action of fluoxetine on dysthymia. The finding that 50% of the non-responders at 3 months were improved at 6 months, after fluoxetine dosage was increased to 40 mg daily, argues in favour of treating dysthymic patients for at least 6 months, and with a higher dosage if the initial doses are ineffective.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 4 , April 1997 , pp. 345 - 350
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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