What is your preferred antipsychotic for augmenting treatment of major depressive disorder?

Over the years, the overpromotion of antipsychotics as augmenting agents was largely initiated by experts with industry ties, often underemphasizing their significant neurological and metabolic side-effect burden. Today, the trend I see is that their primary use has shifted toward primary care physi...

I try to refrain from using antipsychotics in a person who isn’t psychotic. While there are a handful of medications on the market that have been FDA-approved as an adjunct for depression, I tend to shy away because antipsychotics aren’t benign medications. I’ve seen people develop TD over just one ...

None. The statistical benefit of antipsychotic augmentation stinks (1 in 6 or so). I suspect few prescribers tell the patient this "success rate", let alone the potential for tardive dyskinesia (which I have seen with others prescribing AP in this way).

Too many practitioners abandon a potentially h...

I've had the most experience with aripiprazole, seeing patients benefit from this with limited side effects (I don't go over 5 mg for MDD). I tend to use it for patients who could benefit from some dopamine but don't tolerate bupropion.

Metabolic side effects from quetiapine limit its utility. Luras...

My go-to had been Abilify but I’ve been trying Rexulti and Caplyta with encouraging results.