here is an extract...
from about.com
What Is Atypical Depression?
In addition to the core symptoms of depression, atypical depression is defined by the ability to feel better temporarily in response to a positive life event, plus any two of the following criteria: excessive sleep, overeating, a feeling of heaviness in the limbs and a sensitivity to rejection.
Patients with atypical depression tend to have an earlier age of onset than those with other subtypes (it often first appears in the teenage years). These patients are also likely to have a history of social phobia, avoidant personalities and a history of body dysmorphic disorder
Despite the name, atypical depression is actually the most common subtype, according to Dr. Andrew A. Nierenberg, associate director of the depression clinical and research program at Massachusetts General Hospital, Boston. In a 1998 study, he and his associates found that 42% of participants had atypical depression, 12% had melancholic depression, 14% had both depression subtypes, and the rest had neither. "It's more common than we all think. There's no doubt we underrecognize it,"said Dr. Nierenberg.1
Making a correct diagnosis of this subtype is critical in providing the patient with effective treatment. Although SSRIs and other newer medications are often the first line choice for depression treatment due to their favorable side-effect profiles, very little is yet known about how well these work for the patient with atypical depression.
What is known is that patients respond well to MAOIs, but not to tricyclics. Data on newer medications is sparse and inconclusive.2 How many patients out there may be suffering through drug trial after drug trial simply because their physician does not know which medication best treats atypical depressions or does not recognize this distinct subtype?
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