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 .
A randomized, double-blind comparison of olanzapine/fluoxetine combination, olanzapine, and fluoxetine in treatment-resistant major depressive disorder.
OBJECTIVE Two parallel , 8-week double-blind studies compared olanzapine/fluoxetine combination , olanzapine , and fluoxetine in out patients with treatment-resistant depression ( TRD ) . METHOD Treatment-resistant depression was defined as a documented history of current-episode antidepressant failure plus a prospect i ve failure on fluoxetine .  Following an 8-week fluoxetine lead-in , 605 nonresponders with DSM-IV major depressive disorder were r and omly assigned to olanzapine/fluoxetine combination , olanzapine , or fluoxetine . The primary outcome measure was baseline-to-endpoint mean change on the Montgomery-Asberg Depression Rating Scale ( MADRS ) . The study was conducted from April 2002 to May 2005 . RESULTS After 8 weeks of double-blind treatment , Study 1 revealed no statistically significant therapy differences in MADRS mean change  ( olanzapine/fluoxetine combination : -11.0 , fluoxetine : -9.4 , olanzapine : -10.5 ) . In Study 2 , olanzapine/fluoxetine combination demonstrated significantly greater MADRS improvement ( -14.5 ) than fluoxetine ( -8.6 , p < .001 ) and olanzapine ( -7.0 , p < .001 ) . Pooled study results revealed significant differences for olanzapine/ fluoxetine combination ( -12.7 ) versus fluoxetine ( -9.0 , p < .001 ) and olanzapine ( -8.8 , p < .001 ) . Pooled remission rates were 27 % for olanzapine/ fluoxetine combination , 17 % for fluoxetine , and 15 % for olanzapine .  Adverse events were consistent with previous studies . Cholesterol mean change ( mg/dL ) was + 15.1 for olanzapine/ fluoxetine combination , + 0.8 for fluoxetine , and + 2.7 for olanzapine .  Mean weight change ( kg ) was + 4.9 for olanzapine/fluoxetine combination , + 0.4 for fluoxetine , and + 5.5 for olanzapine .  Nonfasting glucose mean change ( mg/dL ) was + 11.4 for olanzapine/fluoxetine combination , + 4.9 for fluoxetine , and + 9.9 for olanzapine . CONCLUSION Patients with TRD ( defined as treatment failure on 2 antidepressants ) taking olanzapine/fluoxetine combination demonstrated significantly greater improvement in depressive symptoms than patients taking olanzapine or fluoxetine in 1 of 2 studies and in the pooled analysis . When considered within the context of all available evidence , olanzapine/fluoxetine combination is an efficacious therapy for patients with TRD . CLINICAL TRIALS REGISTRATION Clinical Trials.gov identifier : NCT00035321
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 .