Document Detail

Second-generation antipsychotics in major depressive disorder: update and clinical perspective.
MedLine Citation:
PMID:  21088586     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: The aim of this systematic review was to examine the efficacy and safety of second-generation antipsychotics (SGAs) in nonpsychotic major depressive disorder (MDD).
RECENT FINDINGS: In MDD, SGA monotherapy or adjunctive therapy to conventional antidepressants showed rapid onset of antidepressant efficacy. Although maintenance data are limited, quetiapine monotherapy, risperidone adjunctive therapy, and amisulpride adjunctive therapy significantly delayed the time to relapse as compared with placebo. In general, extrapyramidal symptoms appeared to be low with SGAs, but a higher incidence of akathisia was observed with aripiprazole. An elevated risk of weight gain was observed with olanzapine-fluoxetine combination, risperidone, aripiprazole, and quetiapine compared with placebo. At present, there are insufficient data to confidently distinguish between different SGAs in the treatment of MDD. A recent meta-analysis found that adjunctive SGAs were significantly more effective than placebo, but differences in efficacy were not identified among the studied agents, nor were outcomes affected by trial duration or the method of establishing treatment resistance.
SUMMARY: Both SGA monotherapy and adjunctive therapy showed greater efficacy in the treatment of MDD than placebo, but augmentation is more widely utilized in treatment-resistant depression. Clinicians should routinely monitor for cardiometabolic side-effects and extrapyramidal symptoms during SGA therapy.
Jun Chen; Keming Gao; David E Kemp
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in psychiatry     Volume:  24     ISSN:  1473-6578     ISO Abbreviation:  Curr Opin Psychiatry     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2011-04-01     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  8809880     Medline TA:  Curr Opin Psychiatry     Country:  United States    
Other Details:
Languages:  eng     Pagination:  10-7     Citation Subset:  IM    
Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
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MeSH Terms
Antidepressive Agents / administration & dosage
Antipsychotic Agents / adverse effects,  therapeutic use*
Benzodiazepines / adverse effects,  therapeutic use
Depressive Disorder, Major / drug therapy*
Dibenzothiazepines / adverse effects,  therapeutic use
Drug Therapy, Combination
Piperazines / adverse effects,  therapeutic use
Quinolones / adverse effects,  therapeutic use
Risperidone / adverse effects,  therapeutic use
Sulpiride / adverse effects,  analogs & derivatives,  therapeutic use
Grant Support
Reg. No./Substance:
0/Antidepressive Agents; 0/Antipsychotic Agents; 0/Dibenzothiazepines; 0/Piperazines; 0/Quinolones; 106266-06-2/Risperidone; 12794-10-4/Benzodiazepines; 132539-06-1/olanzapine; 15676-16-1/Sulpiride; 82VFR53I78/aripiprazole; AA0G3TW31W/sultopride; BGL0JSY5SI/quetiapine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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