What is the best treatment for dysthymia, and what steps can you take to improve it?

hm, and your sure this is dysthymia? for the most part that disorder is a fairly weaker form of depression (just cronic). this seems more like depression to major depression. Amitriptyline is more effective than SSRIs and SNRIs in most cases so if this isnt working then its hard to say it is this disorder. annyway the sleep problem is tricky depending on if you have hyper or hypo somnia. I do hope you are seeking additional help besides drug treatment, such as cognitive behavioral therapy and or talk therapy

as for specific treatment through meds that is completely specific to the individual, however GABA drugs (xanax, valium(<-I approve of this one the most b/c the half life is 2 days), ativan, Klonopin) have been proven to have antidepressant effects. you can also try an MAOI or an SNRI of SSRI + antipsychotic to regulate the neurotransmiters (i dont know if you can use MAOIs or Tricyclics with antipsychotics)

When did you start taking elavil? If it has been some time maybe you need to be reevaluated. Having all these mixed emotions are awful. I am sorry I can't help mor but maybe you doctor can reevaluate. I am going to start a journal to bring with me at my next visit. Good Luck and God Bless

Hi. Thanks a lot for the advice.
Personally what I find with Amitriptyline is that it seems to help me sleep through the night fairly well, which is a big thing for me, and this is why i have stayed on it for the last couple of years, even though the mood problem is still there. Having said that i know my mood would be a lot worse if i wasnt sleeping! I have once tried to come off amitriptyline and switch medications but i find my sleep immediately becames disturbed,so ive stayed on it. Anyone with any further suggestions? Thanks.