Antidepressants can be a lifeline for the 18 million Americans a year who feel overwhelmed by sadness and despair. Yet more than half of the people who take those medications continue to suffer stubborn depressive symptoms.
In such cases doctors can increase the dose, switch to another antidepressant, or recommend psychotherapy. But these days more and more patients instead receive a second drug to boost the partial effects of the first. And to that end doctors are increasingly prescribing powerful medications whose primary domain has been the treatment of psychosis. Several of these antipsychotic medications, including quetiapine (Seroquel), have become particularly popular for use in treating depression.
Known as atypical or second-generation antipsychotics, quetiapine and others in this class are approved by the Food and Drug Administration (FDA) to treat schizophrenia and, in most cases, bipolar disorder. But their off-label use for depression, anxiety, and other non-psychotic disorders has become so widespread that antipsychotic medications are now the top revenue-producing class of drugs in the U.S. Three of them-aripiprazole (Abilify), olanzapine (combined with an antidepressant and sold as Symbyax), and now the extended-release version of quetiapine (Seroquel XR)-recently gained FDA approval for the treatment of depression that hasn't responded to an antidepressant alone. With quetiapine as the most recent addition to the list, is it a good idea to add this drug to your antidepressant treatment regimen?
This off-label drug use report is made possible through collaboration between Consumer Reports Best Buy Drugs and the American Society of Health-System Pharmacists. This is the seventh article in a series based on professional reports prepared by ASHP.
These materials were made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multi-state settlement of consumer fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin)