Conclusion/Depression and Its Subtypes: A Treatment Update




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In this Supplement, Andrew A. Nierenberg, M.D., has reviewed the large body of clinical trials that have demonstrated a specific pharmacologic response for the depressive subtype termed atypical depression, defined by the presence of mood reactivity combined with 2 of the following: hypersomnia, hyperphagia, leaden paralysis, and/or rejection sensitivity. For patients with this profile of depressive symptoms, the monoamine oxidase inhibitor (MAOI) phenelzine proved superior to the tricyclic antidepressant (TCA) imipramine. The combination of a welldefined symptom profile and evidence of a preferential response to one class of antidepressants over another gives important support to the impetus to identify subtypes of patients with major depression.

J Clin Psychiatry 1998;59(suppl 18):37–38