{ "schema_version": 1, "kind": "condition", "id": "dysthymia", "name": "Dysthymia (Persistent Depressive Disorder)", "category": "acute", "sources": "Escitalopram 10 mg film-coated tablets SmPC section 4.2 Posology and method of administration (eMC product 7069) · Fluoxetine 20 mg Capsules SmPC section 4.2 Posology and method of administration (eMC product 11909) · LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070) · Patel RK, Aslam SP, Rose GM. Persistent Depressive Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK541052.", "review_status": "reviewed", "verified_against": "LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070) · SmPC section 4.2, https://www.medicines.org.uk/emc/product/11909/smpc · SmPC section 4.2, https://www.medicines.org.uk/emc/product/7069/smpc · Patel RK, Aslam SP, Rose GM. Persistent Depressive Disorder. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Bookshelf ID: NBK541052.", "verified_date": "2026-08", "treatments": [ { "id": 628, "generic": "Sertraline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 50.0, "adult_dose": "50 mg once daily, titrate up to max 200 mg daily if required", "adult_duration": "Long-term", "dose_source": "LUSTRAL ® 50 mg film coated tablets SmPC section 4.2 Posology and method of administration (eMC product 1070)", "rationale": "Standard SSRI starting dose, equally applicable to the chronic low-grade depression of dysthymia as to anxiety or major depression.", "cautions": [ "Onset of benefit takes 2-4 weeks; warn the patient in advance so they do not stop early.", "Monitor for worsening mood or suicidal ideation in the first 2-4 weeks, especially under age 25.", "Do not combine with MAO inhibitors; taper rather than stop abruptly.", "Refer to psychiatry if there is no response, risk features develop, or a superimposed major depressive episode ('double depression') occurs.", "RED FLAG - Suicidal ideation or self-harm risk, or psychotic features: refer to psychiatry urgently." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Should not be used in the treatment of children and adolescents under the age of 18 years, except for patients with obsessive compulsive disorder aged 6-17 years old.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "OPIRALINE 50 MG 20 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL-OBOUR", "price_egp": 29.0, "pack_count": 20, "unit_price": 1.45, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "AGRELOCIT 50 MG 20 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS > ATM PHARMACEUTICAL INDUSTRIES", "price_egp": 34.8, "pack_count": 20, "unit_price": 1.74, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DEPR-STAT 50MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEMPHIS", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SESERINE 50MG 30 TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 75.0, "pack_count": 30, "unit_price": 2.5, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SERPASS 50MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS", "price_egp": 102.0, "pack_count": 30, "unit_price": 3.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "SIRTO 50MG 10 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HI-PHARM", "price_egp": 34.0, "pack_count": 10, "unit_price": 3.4, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOODAPEX 50 MG 30 F.C.TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 111.0, "pack_count": 30, "unit_price": 3.7, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "LUSTRAL 50 MG 20 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "VIATRIS", "price_egp": 136.0, "pack_count": 20, "unit_price": 6.8, "strength_mg": 50.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysthymia" }, { "id": 629, "generic": "Escitalopram", "line": 2, "is_adjunct": false, "form": "oral.solid", "strength_mg": 10.0, "adult_dose": "10 mg PO once daily, may increase to max 20 mg once daily.", "adult_duration": "Long-term (continue 6-12 months)", "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/7069/smpc", "rationale": "Same standard SSRI starting dose used across the depressive/anxiety spectrum, appropriate for persistent depressive disorder.", "cautions": [ "Alternative first-line SSRI if sertraline is not tolerated or preferred.", "Onset of benefit takes 2-4 weeks.", "Escitalopram is contraindicated in patients with known QT interval prolongation or congenital long QT syndrome, and together with medicinal products that are known to prolong the QT interval." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Contraindicated / not recommended in children and adolescents under 18 years.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "ESCTIKANA 10 MG 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "HOCHSTER PHARMACEUTICAL INDUSTRIES", "price_egp": 17.0, "pack_count": 14, "unit_price": 1.21, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CITALOMEP 10 MG 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MEPACO", "price_egp": 26.0, "pack_count": 14, "unit_price": 1.86, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ECANOPRAM 10 MG 14 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "FUTURE PHARMACEUTICAL INDUSTRIES (FPI) > EGYPTIAN CANADIAN FOR DRUG", "price_egp": 30.0, "pack_count": 14, "unit_price": 2.14, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "MOODAMASH 10 MG 14 F.C. TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MASH PREMIERE", "price_egp": 63.0, "pack_count": 14, "unit_price": 4.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EXCELSA 10 MG 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHAROPHARMA", "price_egp": 66.0, "pack_count": 14, "unit_price": 4.71, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ESCITA 10 MG 14 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GENESIS PHARMACEUTICALS", "price_egp": 77.0, "pack_count": 14, "unit_price": 5.5, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIPRAPRO 10 MG 30 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MARCYRL PHARMACEUTICAL INDUSTRIES (MPI) > COPAD PHARMA", "price_egp": 237.0, "pack_count": 30, "unit_price": 7.9, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "CIPRALEX 10 MG 28 F.C.TABS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "LUNDBECK > MULTIPHARMA", "price_egp": 392.0, "pack_count": 28, "unit_price": 14.0, "strength_mg": 10.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "XYGAROT 5MG/5ML SYRUP 100ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MULTI-APEX", "price_egp": 21.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null }, { "trade_name": "ESCITALOBORG 5 MG/5ML SYRUP 125 ML", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "BORG", "price_egp": 50.0, "pack_count": null, "unit_price": null, "strength_mg": 5.0, "exact_strength": false, "exact_form": false, "discontinued": false, "also_contains": null } ], "condition_id": "dysthymia" }, { "id": 630, "generic": "Fluoxetine", "line": 3, "is_adjunct": false, "form": "oral.solid", "strength_mg": 20.0, "adult_dose": "20 mg PO once daily.", "adult_duration": "Long-term (continue 6 months post-remission)", "dose_source": "SmPC section 4.2, https://www.medicines.org.uk/emc/product/11909/smpc", "rationale": "The same SSRI dose used for major depressive disorder is appropriate for the chronic low-grade depression of dysthymia.", "cautions": [ "Alternative SSRI, useful if the patient has fatigue or low energy given its more activating profile.", "Monitor closely for suicidal ideation in young adults during initial weeks.", "Do not combine with MAO inhibitors or other serotonergic drugs." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Age 8-17y (specialist supervised): start 10 mg (2.5 ml oral solution) once daily, may increase after 1-2 weeks to 20 mg once daily.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "8 to under 18 years", "age_min_months": 96, "age_max_months": 215, "dose_text": "Specialist supervised: start 10 mg (2.5 mL oral solution) once daily; may increase after 1 to 2 weeks to 20 mg once daily." } ], "peds_doses": null, "brands": [ { "trade_name": "FLOROSIN 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UP PHARMA", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHILOZAC 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUOXETINE 20 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "MISR", "price_egp": 18.6, "pack_count": 10, "unit_price": 1.86, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "ELEVAMOOD 20 MG 28 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "UNIPHARMA", "price_egp": 56.0, "pack_count": 28, "unit_price": 2.0, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "OCTOZAC 20MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "OCTOBER PHARMA", "price_egp": 21.6, "pack_count": 10, "unit_price": 2.16, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PHILOZAC 20MG 30 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "AMOUN", "price_egp": 75.0, "pack_count": 30, "unit_price": 2.5, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PROZAC 20MG 14 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ELI LILLY", "price_egp": 118.0, "pack_count": 14, "unit_price": 8.43, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "FLUOXETINE 20 MG H.G.CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 8.0, "pack_count": null, "unit_price": null, "strength_mg": 20.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "dysthymia" } ] }