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 effectiveness of olanzapine, risperidone, quetiapine, and ziprasidone as augmentation agents in treatment-resistant major depressive disorder.
BACKGROUND Many questions remain regarding the use of atypical neuroleptics as antidepressant augmentation agents . To date , there have been no reports in the literature regarding the effectiveness of these drugs when trials of one or more of them have failed previously as antidepressant augmentation . METHOD This retrospective chart review was conducted to determine the effectiveness of olanzapine , risperidone , quetiapine , and ziprasidone when given in a fee-for-service setting as anti-depressant augmentation agents to patients with treatment-resistant , nonpsychotic major depressive disorder ( DSM-IV ) . Prospect i ve ( Global Assessment of Functioning [ GAF ] ) along with retrospective ( Clinical Global Impressions-Improvement [ CGI-I ] and -Severity of Illness scales ) ratings were completed for each patient . Analyses were conducted in an attempt to identify factors that appeared to correlate with response , including order of administration and Thase-Rush staging of treatment resistance . RESULTS In this study of 76 medication trials in 49 patients , the overall response rate based on the CGI-I ratings was 65 % ( 32/49 ) . Individual rates of response were 57 % ( 21/37 ) for olanzapine , 50 % ( 7/14 ) for risperidone , 33 % ( 6/18 ) for quetiapine , and 10 % ( 1/10 ) for ziprasidone . None of the differences between neuroleptics in rates of response were significant . The difference between baseline and final GAF scores was statistically significant only in the olanzapine ( p < .001 ) and risperidone ( p = .047 ) groups . Rates of discontinuation did not vary significantly between agents , though trends were present . Crossover trials from one atypical neuroleptic to another in the event of nonresponse appeared to be effective . CONCLUSIONS Although limited by its design , this study suggests atypical neuroleptic augmentation of antidepressants may be a viable option in treatment-resistant major depressive disorder
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 .