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 .
Extended-release quetiapine as adjunct to an antidepressant in patients with major depressive disorder: results of a randomized, placebo-controlled, double-blind study.
OBJECTIVE This 6-week , r and omized , double-blind study evaluated efficacy and safety of adjunctive extended-release ( XR ) quetiapine in patients with major depressive disorder ( MDD ) and an inadequate response to > or= 1 antidepressant . METHOD Male or female patients aged 18 to 65 years with DSM-IV-TR MDD were r and omly assigned to receive quetiapine XR ( 150 or 300 mg/day ) or placebo adjunctive to continuing antidepressant . Primary endpoint was change from r and omization to week 6 in Montgomery-Asberg Depression Rating Scale ( MADRS ) total score . Secondary variables included MADRS response ( > or= 50 % reduction in score from r and omization ) at weeks 1 and 6 , MADRS remission ( < or= 8 total score ) at week 6 , and week 6 change in Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety total scores . Safety was assessed throughout the study . The study was conducted between May 8 , 2006 , and April 7 , 2007 . RESULTS Four hundred ninety-three patients were r and omly assigned . Mean change from r and omization to week 6 in MADRS score was -15.26 and -14.94 for quetiapine XR 150 mg/day and 300 mg/day , respectively ( both p < .01 vs. placebo [ -12.21 ] ) . Quetiapine XR showed separation from placebo in MADRS score from week 1 ( p < .001 ) onward . The MADRS response rates were 55.4 % , 57.8 % , and 46.3 % for quetiapine XR 150 mg/day ( p = .107 vs. placebo ) , 300 mg/day ( p < .05 ) , and placebo , respectively ; MADRS remission rates were 36.1 % ( p < .05 vs. placebo ) , 31.1 % ( p = .126 ) , and 23.8 % for quetiapine XR 150 mg/day , 300 mg/day , and placebo , respectively . Withdrawal rates due to adverse events were 6.6 % , 11.7 % , and 3.7 % with quetiapine XR 150 mg/day , 300 mg/day , and placebo , respectively . The most common adverse events were dry mouth ( 20.4 % , 35.6 % , and 6.8 % ) and somnolence ( 16.8 % , 23.3 % , and 3.1 % ) . CONCLUSIONS Adjunctive quetiapine XR ( 150 mg/day and 300 mg/day ) was effective  in patients with MDD who had shown an inadequate response to antidepressant treatment . Significant reduction of depressive symptoms occurred as early as week 1 . Findings were consistent with the known safety and tolerability profile of quetiapine . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00351910
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 .