Atypical antipsychotics are used in the treatment of the depressive phase of bipolar disorder. The use of classical antipsychotics is limited to a number of points. Patients with bipolar disorder after treatment with classical antipsychotics are at risk of developing extrapyramidal disorders and dyskinesia. Classical antipsychotics also cause depression, so atypical antipsychotics should be preferred.
When studying the effect of olanzapine and quetiapine , a decrease in psychotic symptoms, good tolerance, and antidepressant effect were found. Monotherapy with olanzapine and its combination with fluoxetine are also effective . Moreover, the combined use of drugs was more effective than monotherapy . The time to depression for olanzapine was 57 days, and 32 days for combined therapy.
Side effects when using drugs: drowsiness, weight gain, increased appetite, dry mouth.
Quentiapine monotherapy was well tolerated in the treatment of depression in patients with bipolar disorder . But the following side effects were observed: sedation , dry mouth, dizziness. Quentiapine also reduced anxiety.
A study by Doree JP et al. In patients with resistant depression showed that supplementation with quentiapine and lithium improved the condition of patients. Moreover, the antidepressant / quetiapine combination was found to be more effective than the antidepressant / lithium combination.
The antidepressant effect of risperidone has not received evidence, but it potentiated the effect of citalopram in resistant depression ( Rapaport MN et al ., 2004). Small doses of amisulpride also had antidepressant effects
Atypical antipsychotics affect not only the main symptoms of depressive disorders, but are effective against psychotic symptoms.