The Safety of Antipsychotics for Depression

Using antipsychotics for depression is one of the most common augmentation strategies for patients with treatment-resistant depression. Drugs such as Seroquel, Abilify, Rexulti, and Zyprexa are often prescribed when antidepressants don't work on their own, especially if a patient doesn't see relief from symptoms after two classes of medications. While these medications can be helpful, doctors and patients alike often underestimate the risks with this augmentation strategy. Atypical antipsychotics can be associated with problematic side effects and shrinking areas of the brain that house our neurons and neuron cell bodies. Is Transcranial Magnetic Stimulation (TMS) safe as an alternative to antipsychotics for depression?

If atypical antipsychotics aren't working for you as an augmentation strategy or if the side effects from these medications are causing too many health problems, you have many other options. For example, you can ask your doctor for a different atypical antipsychotic with fewer metabolic consequences. You can ask to try another augmentation strategy, like using Lithium, which doesn't have the same side effects. Evidence-based psychotherapy can help. Spravato, a nasal spray the Food and Drug Administration approved last year, is another effective treatment. Electroconvulsive therapy and vagus nerve stimulation are other options, but they're often reserved for patients who have tried many other therapies or those who are very ill.

Is TMS safe as another option? The answer might surprise you. A non-drug alternative for treatment-resistant depression that neither results in the side effects associated with atypical antipsychotics nor damages the brain, TMS may actually be associated with better brain health. Think of TMS like physical therapy for the brain—it enhances chemicals associated with increased brain complexity, and it may improve neuronal function over time. In observational trials, the response rate of TMS is upwards of 62 percent, which weighs favorably against any other strategy for treatment-resistant depression. The most important point here is to talk to your doctor about augmentation strategy options beyond atypical antipsychotics and the side effects that go hand in hand with them. If you would like to learn more about TMS therapy, you can set up a free consultation. Treatments are non-invasive, our centers are conveniently located, and we are providers on most insurance plans.