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Re: which ANTIPSYCHOTIC helps most for depression?? » bipolarspectrum

Posted by cache-monkey on June 1, 2005, at 0:57:01

In reply to which ANTIPSYCHOTIC helps most for depression??, posted by bipolarspectrum on May 31, 2005, at 22:10:40

Only three of the atypicals have been clinically studied for their efficacy in bipolar depression: Risperdal, Seroquel and Zyprexa. The work on Risperdal is based on small samples and seems to be mixed. Zyprexa has some anti-depressant effect, but is much more potent when combined with Prozac.

A recent study found that Seroquel had a remarkably strong antidepressant effect (at doses of 300 and 600 mg). Much stronger than that found with Zyprexa monotherapy. Basically the total effect on the MADRS scores from Seroquel alone was equivalent to Zyprexa plus Prozac. Also, in terms of monotherapy Seroquel seperated from the placebo on 8-9 out of ten items on the MADRS, while Zyprexa only did so on 3.

The big drawback of Seroquel, though, seems to be somnolence/sedation (probably a function of super-strong H-1 blockade), which was the leading source of drop-outs in the BOLDER study. Some people are more susceptible to this than others, and this can also potentially drive weight gain.

HTH,
cache-monkey


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