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New Strategies for Treating Chronic Depression

James H. Kocsis, MD

Published: September 30, 2000

Article Abstract

This article provides an update on the diagnosis of chronic depression subtypes, the clinical andpublic health significance of chronic depression, and a review of what is known about its treatment.The efficacy of antidepressant medications for pure dysthymia and double depression has been established,yet fewer than 50% of patients have achieved full remission with a single agent. Traditional antidepressantpsychotherapies appear to have limited effectiveness for chronic depression. In one recentstudy, a combination of cognitive behavioral analysis system of psychotherapy and a newer antidepressant,nefazodone, yielded the highest response and remission rates ever reported in this population(73% response rate, 48% remission rate in an intent-to-treat sample). This combination merits furtherstudy for treatment of chronic depression.

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