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Use of risperidone as augmentation treatment for major depressive disorder
Ryan K Owenby1, Lindsey T Brown, Jamie N Brown
1Durham VA Medical Center, Durham, NC, USA. owenbyr@gmail.com
The Annals of Pharmacotherapy
|December 30, 2010
Summary
Risperidone augmentation may improve major depressive disorder (MDD) response in non-responders, but long-term safety is unknown. Consider other treatments first, and educate patients on potential benefits and side effects.
Area of Science:
- Psychiatry and Pharmacology
- Neuroscience
Background:
- Major depressive disorder (MDD) often requires augmentation strategies when antidepressant monotherapy is insufficient.
- Treatment-resistant depression presents a significant clinical challenge.
Purpose of the Study:
- To evaluate the efficacy and safety of risperidone as an augmentation treatment for patients with MDD.
- To assess risperidone's role in patients who do not respond adequately to standard antidepressant treatments.
Main Methods:
- Systematic review of English-language, peer-reviewed publications from MEDLINE and EMBASE databases.
- Inclusion of four clinical trials and one subanalysis focusing on risperidone augmentation in MDD.
Main Results:
- Risperidone, an atypical antipsychotic, demonstrated antidepressant properties via serotonergic and dopaminergic receptor activity.
- Low-dose risperidone (0.25-2 mg/day) showed potential efficacy and safety in improving depressive symptoms across studies.
- Common adverse effects included headache, dry mouth, and increased appetite.
Conclusions:
- Risperidone adjunctive therapy may enhance response and remission rates in treatment-resistant depression.
- Long-term effectiveness and safety data for risperidone augmentation are currently insufficient.
- Prior adequate trials of first-line agents are recommended before initiating risperidone, with patient education on risks and benefits being crucial.
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