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Treatments and drugs
By Mayo Clinic staff
Treatment options: Medications and psychotherapy
The two main treatments for dysthymia are:
- Medications
- Psychotherapy
There's no clear evidence that either of these treatments is better than the other. There is some evidence, though, that using a combination of medications and psychotherapy may be slightly more effective in treating dysthymia than using only medications or only psychotherapy.
Which treatment approach you take depends on such factors as:
- The severity of your dysthymia symptoms
- Your desire to address emotional or situational issues affecting your life
- Your personal preferences
- Previous treatment methods
- Your ability to tolerate medications
- Whether you're pregnant or breast-feeding
- The availability of mental health services in your community
- Your health insurance coverage
Medications for dysthymia
The psychiatric medications most commonly used to treat dysthymia are the same kinds used to treat depression. They include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- Combined reuptake inhibitors and receptor blockers
- Tetracyclic antidepressants
- Tricyclic antidepressants (TCAs)
- Monoamine oxidase inhibitors (MAOIs)
SSRIs are often the antidepressant of choice because, in general, they work well and their side effects are more tolerable. MAOIs are usually last choices because they can have serious side effects and require strict dietary restrictions because of rare but potentially fatal interactions. Which one is best for you depends on your individual situation. When you have dysthymia, you may need to take antidepressants long term to keep symptoms under control.
The Food and Drug Administration (FDA) requires that all antidepressant medications carry black box warnings. These are the strictest warnings that the FDA can issue for prescription medications. The antidepressant warnings note that in some cases, children, adolescents and young adults ages 18 to 24 may have an increase in suicidal thoughts or behavior when taking antidepressants.
Psychotherapy for dysthymia
Psychotherapy can help you learn about your condition and your mood, feelings, thoughts and behavior. Using the insights and knowledge you gain in psychotherapy, you can learn healthy coping skills and stress management. Psychotherapy can be especially helpful if:
- You need help learning to make decisions
- You have self-defeating behavior patterns
- You also have other mental illnesses, such as an anxiety disorder
- You have a history of traumatic life experiences
Types of psychotherapy
Several types of psychotherapy may be helpful for dysthymia, including:
- Cognitive behavioral therapy
- Interpersonal therapy
- Cognitive therapy
- Behavior therapy
You and your therapist can talk about which type of therapy is right for you, your goals for therapy, and other issues, such as the number of sessions and length of treatment.
