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, fluoxetine, and venlafaxine in treatment-resistant depression.
Based on preliminary evidence of its usefulness in treatment-resistant depression ( TRD ) , an olanzapine/fluoxetine combination ( OFC ) was examined in comparison with olanzapine , fluoxetine , and venlafaxine in a TRD population . In this 12-week double-blind study , 483 subjects with unipolar , nonpsychotic TRD , with historic failure on a selective serotonin reuptake inhibitor ( SSRI ) and prospect i ve failure on open-label venlafaxine , were r and omized to an OFC or to an olanzapine , fluoxetine , or venlafaxine monotherapy group . Venlafaxine was continued r and omly in the double-blind acute phase to explore the benefits of continuation versus switching therapy . The Montgomery-Asberg Depression Rating Scale ( MADRS ) total change score at end point was the primary outcome measure . The OFC group had significantly greater improvement in depressive symptoms by week 1 of treatment ( MADRS mean change = -7.2 , baseline = 29.6 ) , in comparison to olanzapine ( -4.8 , P=.03 ) , fluoxetine ( -4.7 , P=.03 ) , or venlafaxine ( -3.7 , P=.002 ) groups and maintained its statistical separation from all three monotherapy groups through week 6 . At end point , the OFC group was significantly different only from the olanzapine group ( -14.1 vs. -7.7 , P<.001 ) . Analysis of a subgroup of subjects who had an SSRI failure in their current depressive episode ( n=334 ) revealed statistical separation from both olanzapine and fluoxetine ( but not venlafaxine ) at end point : OFC ( -14.6 ) versus olanzapine ( -9.4 , P<.001 ) versus fluoxetine ( -10.7 , P=.006 ) versus venlafaxine ( -14.7 , P=.98 ) . The OFC had a safety profile comparable to its component monotherapies ( i.e. , olanzapine and fluoxetine ) , showed a rapid onset of antidepressant effect , and was effective in this TRD sample . At the study end point , OFC , fluoxetine , venlafaxine , and low-dose OFC all appeared to be similarly effective
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 .