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The Atypical Antipsychotics as a New Generation Class of Antidepressants in Clinical Practice

This study was designed to announce and discuss the atypical antipsychotics as a new generation class of antidepressants that had bring forth significant improvement and positive outcome to the management of patients with depressive disorders in clinical practice. Furthermore, there is opportunity for antidepressant activity to arise through a novel mechanism of action as in the case of atypical antipsychotics. In addition, this article further justifies the current pharmacological standpoint of view with respect to repurposing of the atypical antipsychotics as emerging antidepressant agents for the treatment of depressive disorders in clinical practice. From the psychopharmacological point of view, an atypical antipsychotic is efficacious as a sole monotherapy or adjunct-augmenting pharmacotherapeutic agent for the treatment of patients having anxious depression disorders (that is, either major depressive disorder [MDD] or bipolar depression or schizoaffective/psychotic depression with anxiety disorder component). The atypical antipsychotics appear to be more consistently effective in the treatment of bipolar depression and also do not increase the risk of inducing mania or increasing the frequency of bipolar cycling. In fact, patients with depressive disorders tend to even respond far better and become clinically more stable (undergo remission faster) on an atypical antipsychotic alone as monotherapy compared to the other old conventional antidepressant agents, such as tricyclic antidepressant, selective serotonin reuptake inhibitor (SSRI), or serotonin–norepinephrine reuptake inhibitor (SNRI) alone. This is one of the main reasons behind the Food Drug Administration (FDA) approval of a fixed-dose combination of an SSRI with the atypical antipsychotics such as fluoxetine and olanzapine. A fixed-dose combination of an SSRI with the atypical antipsychotics such as fluoxetine and olanzapine has received the FDA approval for the pharmacotherapy of MDD, acute bipolar depression, and schizoaffective (psychotic) depression. Furthermore, a fixed-dose combination of sertraline and aripiprazole is currently undergoing clinical trial investigation for the same indications.