Antipsychotic meds not that helpful for depression, study finds

by Steven Reinberg, Healthday Reporter
Antipsychotic meds not that helpful for depression: study
These drugs, meant for other conditions, come with side effects including weight gain.

(HealthDay)—For people who don't fully respond to antidepressants, adding commonly prescribed antipsychotic drugs appears to be only slightly effective and is linked to unwelcome side effects, a new study finds.

Drugs added to antidepressants (like Prozac, Paxil and Celexa) include the antipsychotic medications (Abilify), (Seroquel), risperidone (Risperdal) and /fluoxetine (Symbyax).

Antipsychotic drugs are traditionally used to treat conditions such as schizophrenia, bipolar disorder and obsessive-compulsive disorder—not depression.

"The evidence supporting the use of antipsychotics in depression is marginal," said lead researcher Glen Spielmans, an associate professor in the department of psychology at Metropolitan State University in St. Paul, Minn.

Antipsychotic treatment of depression has become increasingly widespread but the underlying evidence base puts this practice into question, he said.

"Other options may be as effective, or more effective, and carry a lesser side-effect burden," Spielmans said. For instance, has been shown to be effective for treatment-resistant depression, he said. Cognitive behavioral therapy is a treatment that helps patients try to change their thoughts, feelings and behaviors.

For one expert, these drugs also aren't a first choice for patients who don't respond fully to antidepressants.

"I have mixed results in terms of how effective they are," said Dr. Bryan Bruno, acting chair of psychiatry at Lenox Hill Hospital, in New York City.

"I treat a lot of patients who are on antidepressants and not responding well. Prescribing these drugs is not something I do often because of the costs and because of the ," said Bruno, who was not involved with the study.

Some of these drugs are pricey. For example, Abilify can cost more than $200 a month without insurance, according to the Everyday Health website. With insurance the cost varies by plan.

"I prefer using other strategies like adding other antidepressants, or using brain stimulation treatments, and psychotherapy," Bruno said.

For some patients, however, these can be helpful, including those with insomnia and those whose depression is coupled with a psychosis, he noted.

The report was published in the March issue of the online journal PLoS Medicine.

To gauge the effectiveness of these drugs, Spielmans' team pooled data from 14 studies that compared to an inactive placebo in patients for whom antidepressants weren't enough to relieve depression.

This process, called a meta-analysis, attempts to find common threads from different studies that reveal a pattern, which adds information beyond what one study finds.

The new analysis found these drugs offered only a small benefit in relieving symptoms of depression and little or no benefit in improving patients' quality of life or ability to function.

The drugs did, however, have some unwelcome side effects such as restlessness, sleepiness, weight gain and some abnormal lab test results such as increased cholesterol levels, the researchers reported.

Spielmans suggested that some of the trials they looked at may have tried to boost the perception of the effectiveness of the drug and downplay its side effects.

"Studies were sometimes designed in a biased manner that may have slanted the results," Spielmans said. "Data were sometimes reported in a way that likely made the drugs appear more effective than they actually were."

In addition, he said, the researchers found that some side effects were tucked away on the U.S. Food and Administration's website and in clinical trial registries rather than being reported in the published medical journal reports of the studies.

More information: To learn more about depression, visit the U.S. National Institute of Mental Health.

Related Stories

Use of adjunctive antipsychotic medications in depression

Mar 12, 2013

A study published this week in PLOS Medicine finds that while antipsychotic medications are associated with small-to-moderate improvements in depressive symptoms in adults, there is little evidence for improvement on mea ...

Australians double their antidepressants

Nov 16, 2012

(Medical Xpress)—The use of antidepressants doubled in Australia between 2000 and 2011 and they now account for two out of every three psychotropic medications prescribed, a new study by the University of Sydney reveals.

More kids taking antipsychotics for ADHD: study

Aug 07, 2012

(HealthDay) -- Use of powerful antipsychotic medications such as Abilify and Risperdal to control youngsters with attention-deficit/hyperactivity disorder (ADHD) and other behavior problems has skyrocketed ...

Recommended for you

Brains transform remote threats into anxiety

Nov 21, 2014

Modern life can feel defined by low-level anxiety swirling through society. Continual reports about terrorism and war. A struggle to stay on top of family finances and hold onto jobs. An onslaught of news ...

Mental disorders due to permanent stress

Nov 21, 2014

Activated through permanent stress, immune cells will have a damaging effect on and cause changes to the brain. This may result in mental disorders. The effects of permanent stress on the immune system are studied by the ...

Could there be a bright side to depression?

Nov 21, 2014

(Medical Xpress)—A group of researchers studying the roots of depression has developed a test that leads them closer to the idea that depression may actually be an adaptation meant to help people cope with ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.