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Antipsychotics as antidepressants : what is the mechanism?

There is considerable evidence on efficacy of some SGAs as an adjunction to antidepressants in MDD, and aripiprazole, quetiapine XR and olanzapine plus fluoxetine are yet approved by FDA. Quetiapine XR was proven effective also as a monotherapy. While their mechanism is not completely understood, antagonism of serotonergic and noradrenergic receptors, blockage of monoamine transporters, effects on sleep, decrease in cortisol levels and increase in neurotrophic growth factors seem to be involved. Antipsychotics should be given at a lowest effective dose in patients to MDD, and patients need close monitoring for additional adverse events.

antipsychotics; antidepressants; mechanism

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