TITLE:
Efficacy and Safety of Antipsychotics for the Treatment of Major Depressive Disorder in Adolescents and Adults: Current Issues and Clinical Perspective
AUTHORS:
Raj Rasasingham
KEYWORDS:
Atypical Antipsychotics, Major Depressive Disorder, Depression
JOURNAL NAME:
Open Journal of Psychiatry,
Vol.4 No.3,
July
1,
2014
ABSTRACT: Objectives: Atypical
antipsychotics are increasingly being prescribed for the treatment of mood
disorders, often off-label. This review describes existing published literature
on the efficacy and safety of antipsychotics for the treatment of major
depressive disorder (MDD) in adults and adolescents. We discuss current
clinical considerations: role as monotherapy, adjunctive, or augmentation
therapy, side effect profiles, and optimal dose and duration of therapy.
Potential areas for future research and methodological considerations are also
highlighted. Method: We conducted a literature search of MEDLINE, EMBASE,
PsycINFO, and Cochrane databases. Relevant articles and references were
identified. MDD practice guidelines for adolescents and adults were reviewed.
Results: Evidence for using atypical antipsychotics to treat MDD is
heterogeneous. It is thus difficult to draw firm conclusions regarding their
role in therapy. Most current guidelines do not include recommendations for
atypical antipsychotics, but off-label use is common in clinical practice.
Primary use is adjunct or augmentation therapy for treatment resistant
depression. Potential benefits versus side effects must be cautiously
considered, especially for children and adolescents. Clinicians must rely on
their clinical experience and professional judgment to determine an optimal
dose and duration of therapy. Conclusions: There is progressive research to
support the use of atypical antipsychotics to treat MDD in adults. However,
additional research and well-designed studies are needed to determine the
appropriate and safe use of atypical antipsychotics for treating child and
adolescent depression. Other subpopulations that may benefit from combination therapy,
such as individuals with dual diagnoses, may be identified through future
research.