Evolution of Concept and Treatment of Depression and the Use of Antipsychotic Agents as Adjuvants to Antidepressants

depression, as a categorical mental disorder, has deeply rooted origins in antiquity. It is well perceived that depressive disorder can become chronic and lead to significant impairments in an individual’s socio-occupational functioning and that depressive disorder is ranked as the second leading cause of disease burden worldwide. Despite these serious consequences, and the progress achieved in the field of pharmacotherapy and other varieties of psychiatric treatments, substantial recovery from depression remains a significant challenge in about half the cases. In recent decades, efforts to improve treatment outcome for depression have increased. The use of atypical antipsychotics as adjuvants to antidepressants in the treatment of refractory depression is one such example. The available literature has reported heterogeneous findings with regard to their effects. The current essay examines the origin and evolution of the nosology and management of depression, the concept of refractory depression, and also highlights recent developments in the use of atypical antipsychotics as adjuvant agents in promoting functional recovery in depressed patients.