Maintenance desipramine for dysthymia: a placebo-controlled study

Background: This study examines the efficacy of maintenance pharmacotherapy in dysthymia without concurrent major depression, i.e. ‘pure dysthymia’. No published data exist on this topic. Methods: Responders to a 10-week open trial of desipramine (DMI) whose therapeutic response persisted during a 4-month continuation phase were eligible to begin a 2-year placebo-controlled maintenance phase. We analyzed the subgroup with DSM-III-R pure dysthymia (n=27) that entered maintenance. Time to recurrence during maintenance therapy was compared between the two treatment groups. Results: Six of 13 patients receiving placebo and none of 14 patients receiving ongoing DMI experienced a recurrence. Risk of recurrence was significantly greater for placebo patients. Five of six placebo recurrences occurred within the first 6 months of maintenance. Limitations: Larger replication studies are needed. Conclusions: Desipramine was efficacious as a maintenance treatment in patients with pure dysthymia who responded to 7 months of acute and continuation DMI.