Evaluating atypical antipsychotics in the treatment of refractory depression

Treatment resistance is a common clinical occurrence among patients treated for major depressive disorder. Clinicians have several options when treating resistant depression, including switching antidepressants within the same class, switching outside the class, and augmenting with various agents, including atypical antipsychotics. Atypical antipsychotics have shown efficacy as adjuncts to antidepressants in the treatment of resistant depression, although long-term efficacy is undetermined. Atypical antipsychotics need to be compared for efficacy against specific target symptoms, as well as for differences in safety and tolerability.