Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 9/23/2025

Treatment of Major Depressive Disorder with Mixed Features

Standard Treatment Options

  • The American College of Physicians guidelines recommend second-generation antidepressants (SSRIs, SNRIs) with or without psychotherapy as first-line treatment for major depressive disorder (MDD) 1, 2
  • Cognitive behavioral therapy (CBT) shows equivalent efficacy to antidepressants in treating MDD 4, 3

Atypical Antipsychotics in MDD Treatment

  • Atypical antipsychotics like lurasidone are only FDA-approved as adjunctive treatment in treatment-resistant unipolar MDD, not as monotherapy 1, 2