Management of Treatment Resistant Depression

ABSTRACT Purpose: The purpose of this paper is to review if augmenting antidepressant treatment with atypical antipsychotics improves symptoms of treatment resistant depression as noted on depression scales. Method: A PubMed literature search was conducted with search terms: treatment resistant depression, antidepressants, atypical antipsychotics, and Montgomery-Ashberg Depression Rating Scale (MADRS) depression scales. Three pertinent articles were retrieved. Results: There is evidence-based research to demonstrate the effectiveness of augmenting selective serotonin reuptake inhibitors (SSRI) with atypical antipsychotics to treat treatment resistant major depression disorder based on reduction of scores on depression scales. Conclusion: The results of the studies all showed a reduction in symptoms of depression in patients with inadequate response to standard treatment of depression or treatment resistant depression. The MADRS scale was an endpoint used in each study and each study showed a statistically significant change from baseline through the end of the study. This is particularly interesting because one of the three studies augmented standard antidepressant medication with a different antipsychotic. Keywords: Major Depressive Disorder, Treatment Resistant Depression, Atypical Antipsychotics, and MADRS Scales