What is the pathophysiology of persistent depressive disorder (dysthymia)?

Updated: Oct 01, 2019
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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The involvement of serotonin and noradrenergic systems in dysthymia is suggested by the disease’s positive clinical responses to serotonergic and noradrenergic medications, such as SSRIs, serotonin/norepinephrine reuptake inhibitors (SNRIs), and tricyclic antidepressants.

Abnormalities in neuroendocrine systems, especially thyroid and hypothalamo-pituitary-adrenocortical (HPA) systems, have been linked to depressive disorders in general, although the HPA axis has not been adequately studied in dysthymic disorder.

Cytokines and inflammation have also been implicated in major depression; however, a link to dysthymia has not been clearly established. [9]

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