A pharmacotherapy algorithm for the treatment of dysthymia in Japan

Based on randomized controlled trials conducted in western countries, we proposed a pharmacotherapy algorithm for DSM-IV dysthymia in Japan. The main strategy of the algorithm are: firstly, one of the antidepressants is selected for an initial agent, and secondly, efficacy of the selected antidepressant is evaluated at 8 to 12 weeks. The agent with sufficient efficacy is continued for at least 6 months, while ineffective agent is replaced to another antidepressant. The algorithm is preliminary mainly because of the lack of data from Japanese samples and the unavailability of some useful agents in Japan, for instance, selective serotonin reuptake inhibitors and monoamine oxidase inhibitors.