There were some beneficial effects compared to placebo or antidepressants but tolerability was worse .
Quetiapine was more effective than placebo treatment .
Aripiprazole and quetiapine and partly also olanzapine and risperidone augmentation showed beneficial effects compared to placebo .
Some evidence indicated beneficial effects of low-dose amisulpride for dysthymic people .
Most SGAs showed worse tolerability
BACKGROUND Major depressive disorder ( MDD ) is a common condition with a lifetime prevalence of 15 % to 18 % , which leads to considerable suffering and disability .
Some antipsychotics have been reported to induce remission in major depression , when added to an antidepressant .
OBJECTIVES To evaluate the effects of second-generation antipsychotic ( SGA ) drugs ( alone or augmentation ) compared with placebo or antidepressants for people with MDD or dysthymia .
The Efficacy and Safety of Aripiprazole as Adjunctive Therapy in Major Depressive Disorder: A Second Multicenter, Randomized, Double-Blind, Placebo-Controlled Study
Nonresponse to one or more antidepressants is common and an important public health problem . This study evaluated the efficacy and safety of adjunctive aripiprazole or placebo to st and ard antidepressant therapy ( ADT ) in patients with major depressive disorder who showed an inadequate response to at least 1 and up to 3 historical and 1 additional prospect i ve ADT . The study comprised a 7 - 28-day screening , an 8-week prospect i ve treatment , and a 6-week r and omization phase . During prospect i ve treatment , patients experiencing a major depressive episode ( 17-item Hamilton Rating Scale for Depression total score ≥18 ) received single-blind adjunctive placebo plus clinicians ' choice of ADT ( escitalopram , fluoxetine , paroxetine controlled-release , sertraline , or venlafaxine extended-release ) . Subjects with inadequate response were r and omized to adjunctive placebo ( n = 190 ) or adjunctive aripiprazole ( n = 191 ) ( starting dose 5 mg/d , dose adjustments 2 - 20 mg/d , mean end-point dose of 11.0 mg/d ) . The primary efficacy endpoint was the mean change in Montgomery-Åsberg Depression Rating Scale total score from end of prospect i ve treatment phase to end of r and omized treatment phase ( last observation carried forward ) . Mean change in Montgomery-Åsberg Depression Rating Scale total score was significantly greater with adjunctive aripiprazole than placebo ( −8.5 vs −5.7 ; P = 0.001 ) . Remission rates were significantly greater with adjunctive aripiprazole than placebo ( 25.4 % vs 15.2 % ; P = 0.016 ) as were response rates ( 32.4 % vs 17.4 % ; P < 0.001 ) . Adverse events occurring in 10 % of patients or more with adjunctive placebo or aripiprazole were akathisia ( 4.2 % vs 25.9 % ) , headache ( 10.5 % vs 9.0 % ) , and fatigue ( 3.7 % vs 10.1 % ) . Incidence of adverse events leading to discontinuation was low ( adjunctive placebo [ 1.1 % ] vs adjunctive aripiprazole [ 3.7 % ] ) . Aripiprazole is an effective and safe adjunctive therapy as demonstrated in this short-term study for patients who are nonresponsive to st and ard ADT
There were some beneficial effects compared to placebo or antidepressants but tolerability was worse .
Quetiapine was more effective than placebo treatment .
Aripiprazole and quetiapine and partly also olanzapine and risperidone augmentation showed beneficial effects compared to placebo .
Some evidence indicated beneficial effects of low-dose amisulpride for dysthymic people .
Most SGAs showed worse tolerability
BACKGROUND Major depressive disorder ( MDD ) is a common condition with a lifetime prevalence of 15 % to 18 % , which leads to considerable suffering and disability .
Some antipsychotics have been reported to induce remission in major depression , when added to an antidepressant .
OBJECTIVES To evaluate the effects of second-generation antipsychotic ( SGA ) drugs ( alone or augmentation ) compared with placebo or antidepressants for people with MDD or dysthymia .