Atypical Depression Actually Very Typica 1/23/02 ?

Q.other newer medications are often the first line choice for depression treatment due to their favorable side-effect profiles, very little is yet known about how well these work for the patient with atypical depression. What is known is that patients respond well to MAOIs, but not to tricyclics.

A.the core symptoms of depression, atypical depression is defined by the ability to feel better temporarily in response to a positive life event, plus any two of the following criteria: excessive sleep, overeating, a feeling of heaviness in the limbs and a sensitivity to rejection. Patients with atypical depression tend to have an earlier age of onset than those with other subtypes (it often first appears in the teenage years). These patients are also likely to have a history of social phobia, avoidant personalities and a history of body dysmorphic disorder.3 Current data suggests that those with atypical depression will respond better to MAOIs (monoamine oxidase inhibitors) like phenelzine than they will to imipramine (a tricyclic). Dietary restrictions and side-effects remain a problem. At the present time, research is concentrating on finding newer medications with better side-effect profiles to which these patients will also get a good response.4 Although more research is needed, it seems that patients may also obtain an adequate response with the SSRIs, but not all studies seem to back up this assertion. In one study, the SSRI Prozac was found to have a response only equal to imipramine, a tricyclic whose comparative response to phenelzine is well-known.5 Clinical trials are currently being arranged to test the efficacy of a new drug, Gepirone, at Columbia University in New York City. Preliminary studies seemed to indicate that it is effective for those with atypical depression.

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