Augmentation of standard antidepressants with atypical antipsychotic agents for treatment-resistant major depressive disorder.
Treatment-resistant depression (TRD) is not uncommon; 29% to 46% of patients with depression who are treated with antidepressants fail to respond fully. Dr. Papakostas discusses various augmentation strategies, focusing particular on a possible role for the newer atypical antipsychotics. Their complex neuropharmacological actions suggest such efficacy. One chart review and a number of open-label studies have been encouraging, but 2 double-blind, placebo controlled-studies have offered contradictory results. Considering the side-effect profiles of these drugs, a careful risk/benefit assessment is always required. While routinely used for psychotic depression and panic reactions in depressive disorders, their value as augmenters in TRD awaits further study.
Papakostas
George I
GI
Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003865:Major Depressive Disorder / Q000188:drug therapy*; D004351:Drug Resistance; D004357:Drug Synergism; D006801:Humans
D000928:Antidepressive Agents; D014150:Antipsychotic Agents