In addition to antidepressants, it is becoming more common for physicians to prescribe antipsychotics for patients combating depression. However, new evidence shows that antipsychotic drugs provide few benefits and significant side effects to those who take them.
Since the mid-1990s, prescriptions for antipsychotic medications as "adjunct therapy" have nearly doubled. In a recent study, researchers from Metropolitan State University in St. Paul, Minnesota examined 14 previously conducted randomized clinical trials that used a combination of antidepressants and antipsychotics. The antipsychotics consisted of olanzapine/flueoxetine (brand name Symbyax), quetiapine (brand name Seroquel), aripiprazole (brand name Abilify), and risperidone (brand name Risperdal).
While researchers found that there was a slight benefit in using antipsychotic medication to relieve symptoms that do not respond to antidepressants alone, the patients' overall quality of life did not improve. In fact, patients who took antipsychotics were more likely to experience weight gain, sleepiness, akathisia (a sense of restlessness), and abnormal results on metabolic-related laboratory tests. Instead, the "adjunct therapy" that proved to be most helpful appeared to be cognitive behavioral therapy, which involved communicating with the patient. The combination of antidepressants and cognitive therapy led to not only a decrease in depression, but also a significant improvement in patients' quality of life. Researchers state that if these findings appear in more studies, it may be better for physicians to prescribe cognitive therapy in place of antipsychotics to treat depression.
Not only are antipsychotics associated with weight gain and sleepiness, but also there is some evidence that pregnant women who take them are at a higher risk of giving birth to a baby with birth defects. For example, in 2011, the federal Food and Drug Administration issued a warning about the newer antipsychotic drugs after receiving 69 reports of problems with newborns. Perhaps it is not so surprising, given that some antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), are also linked to birth defects.
If you are pregnant and have depression, it is important that you and your physician discuss a course of treatment that would be as safe as possible. Your physician has a legal duty to discuss the potential dangers of taking any type of medication, so that you can make an informed decision about whether to move forward with, or decline, that form of treatment. If your physician fails to do so -- for instance, if he or she prescribes you antipsychotics without telling you the potential danger to your fetus -- he or she has breached that duty. If you then have a child with a birth defect, you would have the option of suing your physician for medical malpractice. You would argue that had your physician fully informed you of the risks, you never would have taken that medication. By taking it, you exposed yourself and your fetus to the harmful effects, and as a result, your child was born with a birth defect. As always, the strength of your case lies in your being able to show that the medication, and not another cause, was responsible.