Therapeutic strategies in atypical depressive syndrome in the UK

Summary

In the UK, the majority of patients with depressive disorders are treated by general practitioners, and there is little agreement on the nomenclature for atypical disorders including dysthymia, atypical depression, neurasthenia and recurrent brief depression. Mixed depressive and anxiety symptoms are considered to be the norm, and antidepressant drugs are increasingly being used in place of benzodiazepines. Unfortunately, antidepressant regimens prescribed by GPs tend to be inadequate in terms of both duration and dosage, and an educational campaign is underway to remedy this problem. British psychiatrists employ the full range of available antidepressant drugs for depression, and the severity of the disorder is not a primary determinant for choice of drug; on the other hand, ECT is reserved primarily for psychotic depression. Neurasthenia is frequently diagnosed as “chronic fatigue syndrome”, or “myalgic encephalomyelitis”, and a psychological treatment protocol has given encouraging initial results.