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Systematic review
Adding atypical antipsychotics to antidepressants increases response in treatment-resistant major depression but increases discontinuation as a result of adverse events
  1. Gabor I Keitner
  1. Gabor I Keitner
    Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA; GKeitner{at}Lifespan.org

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The outcome of treatment for major depression is suboptimal. Only a minority of patients (<30%) achieve remission with the first antidepressant, and most relapse. Each subsequent treatment trial yields even lower rates of remission. Psychotherapy, similarly, results in a 30% remission rate and a 50% improvement in 50% of depressed patients. Between 15% and 30% of depressed patients have a chronic course of illness despite adequate treatment trials. There is, therefore, a well-established need for new approaches for depressed patients who have not responded well to commonly used antidepressant treatments.

The development of second-generation antipsychotic medications with arguably more benign side effect profiles has led to a renewed interest in their use for the treatment of depression. …

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