{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:09:48Z","timestamp":1784045388433,"version":"3.55.0"},"reference-count":42,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2018,10,16]],"date-time":"2018-10-16T00:00:00Z","timestamp":1539648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the efficacy and safety of using adjunctive antipsychotics in patients with major depressive disorder.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Studies published since the last Cochrane review conducted in 2010 were identified via a literature search of recognised databases, using the keywords \u201cadjunct*\u201d, \u201caugment*\u201d, \u201cantipsychotic\u201d and \u201cdepression\u201d, and systematically evaluated. A targeted review of relevant guidelines was undertaken.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Adjunctive antipsychotics produce a small but significant improvement in depressive symptoms in most studies. Most of the studies focussed on patients with an inadequate response to antidepressants rather than patients with treatment resistant depression. Treatment guidelines were variable but generally supported the use of adjunctive antipsychotics while cautioning about the risk of side effects. Most were non\u2010specific about the length of time adjunctive antipsychotics should be prescribed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The studies do not support the routine use of adjunctive antipsychotics in patients with an inadequate response to antidepressants. They may be beneficial when used short\u2010term in patients with treatment resistant depression who have specific symptoms (severe ruminations, melancholia, major sleep disturbance) that appear to respond well to adjunctive antipsychotics. There is no support for long\u2010term use. Research should focus on specifying which symptom profiles are responsive and how adjunctive antipsychotics compare to other strategies in treatment resistant depression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12701","type":"journal-article","created":{"date-parts":[[2018,10,17]],"date-time":"2018-10-17T06:51:40Z","timestamp":1539759100000},"page":"17-24","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Treating depression with adjunctive antipsychotics"],"prefix":"10.1111","volume":"20","author":[{"given":"Roger","family":"Mulder","sequence":"first","affiliation":[{"name":"Sophisticated Mood Appraisal &amp; Refinement of Treatment (SMART) Group"},{"name":"Department of Psychological Medicine University of Otago\u2014Christchurch  Christchurch New 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