Use of antipsychotics in the treatment of major depressive disorder in an outpatient mental health center

Background

Antidepressants are currently the mainstay of treatment for depression; however, almost two thirds of patients will fail to achieve remission with initial treatment. Evidence has shown that adjunctive therapy with atypical antipsychotics has the potential for beneficial antidepressant effects in the absence of psychotic symptoms [1].

Materials and methods

Using a sample of 100 patients with MDD who have been visited in Barcelona's Sant Martí Sud outpatient mental health center during the year 2008, sociodemographical (gender, age) and clinical data (toxic consume, psychiatric background, use of antipsychotics) are analysed with SPSS 15.0 statistical package

Results

Antipsychotics are used in 27% of the patients, with a predominancy in the female gender (77.8%), a global average age of 57.9 ± 12.6 years. There is a predominancy of absence of psychiatric background (55.6%) and the absence of previous hospitalisations (66.7%). In 96.3% of the sample there was no toxic abuse.

It is observed the following distribution in the use of antipsychotics: quetiapine and olanzapine (29.6% each one), risperidone (26%), paliperidone (3%). Average dose was 5.7 mg/d for olanzapine, 2.3 mg/d for risperidone, 84.5 mg/d for quetiapine and 6 mg/d for paliperidone.

Conclusions

It is observed an important frequency in the use of antipsychotic treatment for MDD, in relation with the fact that there is growing evidence for the efficacy of atypical antipsychotics for adjunctive treatment of depressive symptoms of MDD. There is scientific evidence that supports the use of the two antipsychotics predominantly used in our sample (olanzapine and quetiapine) [2], but more studies are needed to establish its place in management.