Evidence for Using Atypical Antipsychotics in Mood and Anxiety Disorders

At present, there are more small, open-label trials than large, double-blind, placebo-controlled studies of atypical antipsychotics in the treatment of nonpsychotic psychiatric illnesses. Existing evidence indicates both the safety and the efficacy of relatively low doses of the dopaminergic/serotonergic atypical antipsychotics as adjunctive, or augmentation, therapy for patients with nonpsychotic mood and anxiety disorders. In psychiatric practice, atypical antipsychotics are widely used to enhance the action of antidepressants or mood stabilizers in the management of many illnesses, including psychotic and nonpsychotic major depression, bipolar disorder (especially mania), posttraumatic stress disorder, and obsessive-compulsive disorder. Such use of atypical antipsychotics in the primary care setting remains a relatively new concept. Several studies indicate that atypical antipsychotics such as risperidone and olanzapine can improve clinical outcome when used to augment antidepressants or mood stabilizers.