Use of atypical antipsychotics in refractory depression and anxiety

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Abstract

Treatment options for bipolar depression and treatment-resistant unipolar depression include augmentation of antidepressant therapy with a nonantidepressant drug, including atypical antipsychotics. Risperidone is effective in combination with fluvoxamine, paroxetine, or citalopram in treatment-resistant unipolar depression, with reported remission rates of 61% to 76%. Olanzapine in combination with fluoxetine is safe and effective in patients with bipolar depression and those with fluoxetine-resistant unipolar depression. Ziprasidone and aripiprazole augmentation of various selective serotonin reuptake inhibitors has been reported to be effective in refractory unipolar depression in open-label studies. Data on use of quetiapine or clozapine as augmentation therapy for depression or anxiety are not yet available. Further double-blind, placebo-controlled studies of augmentation of antidepressants with atypical antipsychotics in refractory depression and anxiety are justified based on the available literature.

Original languageEnglish (US)
Pages (from-to)13-21
Number of pages9
JournalJournal of Clinical Psychiatry
Volume66
Issue numberSUPPL. 8
StatePublished - Dec 1 2005

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ASJC Scopus subject areas

  • Psychiatry and Mental health

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