Second-generation antipsychotics (SGAs), also known as atypical antipsychotics, are sometimes used to augment antidepressant treatment in cases of treatment-resistant depression. Here are the commonly used SGAs for this purpose, along with typical dosage ranges:
1. Aripiprazole (Abilify)
• Starting Dose: 2-5 mg per day.
• Typical Dose Range: 2-15 mg per day.
• Maximum Dose: 15 mg per day for depression augmentation (higher doses may be used for other conditions, but not typically for depression augmentation).
2. Quetiapine XR (Seroquel XR)
• Starting Dose: 50 mg per day, usually taken at bedtime.
• Typical Dose Range: 150-300 mg per day.
• Maximum Dose: 300 mg per day for depression augmentation.
3. Brexpiprazole (Rexulti)
• Starting Dose: 0.5-1 mg per day.
• Typical Dose Range: 1-3 mg per day.
• Maximum Dose: 3 mg per day for depression augmentation.
4. Olanzapine (Zyprexa)
• Starting Dose: 2.5-5 mg per day.
• Typical Dose Range: 5-20 mg per day.
• Maximum Dose: Generally, 20 mg per day, though for depression augmentation, lower doses (around 5-10 mg) are often used in combination with fluoxetine (Symbyax).
5. Risperidone (Risperdal)
• Starting Dose: 0.25-1 mg per day.
• Typical Dose Range: 1-3 mg per day.
• Maximum Dose: 3 mg per day for depression augmentation.
Important Considerations
• Side Effects: SGAs can cause side effects like weight gain, metabolic changes, sedation, and movement disorders, so monitoring is essential.
• Titration: Starting at a lower dose and gradually increasing helps to minimize side effects.
• Combination Therapy: These medications are generally used alongside an antidepressant rather than as monotherapy for depression.
Each SGA has a different side effect profile, so the choice of medication should be tailored to the individual’s needs and tolerability, under close supervision by a healthcare provider.
