Adding Antipsychotics Worsens Outcomes in Psychotic Depression

Outcomes were worse for all, with young people on combination therapy twice as likely to experience rehospitalization or death by suicide than those on antidepressants alone.

This report by Peter Simons has been published by Mad in America. It begins:

“Antipsychotics for psychotic depression? Not a great idea, according to a new study. Adding an antipsychotic drug to antidepressant treatment increased the risk of death and rehospitalization for people with the psychotic depression diagnosis.

‘Our findings do not indicate any advantage of adding antipsychotics as adjunctive to antidepressants as maintenance treatment. Considering the wide use, known side effects, and the current lack of evidence supporting the benefit, further studies on the effect of antipsychotics in the maintenance phase of psychotic unipolar depression are urgently warranted,’ the researchers write.

The research was conducted by Ahmed Al-Wandi and Axel Nordenskjöld at Örebro University, Sweden, and Mikael Landén at Gothenberg University and the Karolinska Institutet, Sweden. The study was published in Acta Psychiatrica Scandinavica.

The researchers note that it is common practice to give antipsychotic drugs (in addition to antidepressants) to those with psychotic depression, and their results bear this out; in their study, twice as many people got combination therapy. Indeed, the American Psychiatric Association guidelines for treatment of psychotic depression list combination therapy as a first-line intervention, along with electroconvulsive therapy (ECT). Sounds good on the surface, right? If people have ‘psychosis,’ add an ‘antipsychotic’ ….”

You can read more from here.

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