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 .
Olanzapine/fluoxetine combination for treatment-resistant depression: a controlled study of SSRI and nortriptyline resistance.
BACKGROUND This 8-week , double-blind , multicenter study was undertaken to replicate , in a larger sample of patients with treatment-resistant major depressive disorder ( MDD ; DSM-IV criteria ) , the results of a pilot study of the olanzapine/fluoxetine combination . METHOD The study was begun in August 1999 . The primary entry criterion was a history of failure to respond to a selective serotonin reuptake inhibitor ( SSRI ) . Patients ( N = 500 ) who subsequently failed to respond to nortriptyline during an open-label lead-in phase were r and omly assigned to 1 of 4 treatment groups : olanzapine ( 6 - 12 mg/day ) plus fluoxetine ( 25 - 50 mg/day ) combination , olanzapine ( 6 - 12 mg/day ) , fluoxetine ( 25 - 50 mg/day ) , or nortriptyline ( 25 - 175 mg/day ) . The primary outcome measure was baseline-to-endpoint mean change in score on the Montgomery-Asberg Depression Rating Scale ( MADRS ) . RESULTS At the 8-week study endpoint , MADRS total scores decreased by a mean 8.7 points from baseline ( 28.5 ) with the olanzapine/fluoxetine combination , 7.0 points from baseline ( 28.4 ) with olanzapine ( p = .08 ) , 8.5 points from baseline ( 28.4 ) with fluoxetine ( p = .84 ) , and 7.5 points from baseline ( 28.8 ) with nortriptyline ( p = .30 ) , with no significant differences among the therapies . The olanzapine/fluoxetine combination was associated with significantly ( p < or = .05 ) greater improvement ( decrease ) in MADRS scores than olanzapine at weeks 2 , 4 , 6 , and 7 ; than fluoxetine at weeks 2 through 5 ; and than nortriptyline at weeks 1 through 4 . A post hoc analysis of a subgroup of patients who had an SSRI treatment failure during their current MDD episode ( N = 314 ) revealed that the olanzapine/fluoxetine combination group had a significantly ( p = .005 ) greater decrease in MADRS scores than the olanzapine group at endpoint . Safety data for the olanzapine/fluoxetine combination were similar to those for its component monotherapies . CONCLUSIONS The olanzapine/fluoxetine combination did not differ significantly from the other therapies at endpoint , although it demonstrated a more rapid response that was sustained until the end of treatment . The results raised several method ological questions , and recommendations are made regarding the criteria for study entry and r and omization
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 .