The clinical characteristics and treatment of atypical depression

The clinical characteristics, response to pharmacotherapy, and the family history of 15 depressed patients with mixed anxiety and depressive symptomatology are presented. Although these patients manifest the clearcut features of atypical depression, they have several previously unreported features: their primary symptomatology-fatigue, anxiety, and anhedonia-had been present since early adolescence; they responded to tricyclic antidepressant therapy, particularly those agents that increase CNS adrenergic activity; and there was a high loading of psychiatric illness, especially affective disorder and alcoholism, in first degree relatives. A relationship between atypical depression and depressive spectrum disease is hypothesized.