[Atypical depression: evolution toward a specific pharmacologic and efficacious treatment?]

The present article reviews different concepts of atypical depression. Of these, major depression associated with panic disorder would have a specific meaning according to some pharmacological and prognosis studies. It seems that this type of depression is quite frequent and has a significantly worse prognosis than major depression alone. Controlled studies comparing the efficacy of tricyclic antidepressants to phenelzine concluded in favour of the latter in general. It is generally thought that atypical depression would respond better to monoamine oxidase inhibitors (MAOI), but it would seem that it is mainly major depression associated with panic disorder that could predict this kind of response to treatment. Second generation antidepressants have not been studied systematically for this purpose even though preliminary reports seem promising.