Question. I recently heard of the use of a low dose of Thorazine for the treatment of depression. Are you familiar with this treatment?

Answer. I am not aware of any controlled, persuasive evidence that Thorazine (chlorpromazine) or any standard antipsychotic – in low doses or high – is particularly effective as an antidepressant. The exception to this claim may be in so-called delusional depression, in which psychotic features are present; antipsychotics such as Thorazine may be somewhat effective for the agitation and delusional thinking in this condition, but probably not for the core depressive features, such as lack of pleasure, lack of energy, and slowing of mental functions. On the other hand, depression is often encountered as a side effect of standard antipsychotics (neuroleptics).

Having said all this, I would hasten to add that new, atypical antipsychotics, such as risperidone and clozapine, do, indeed, seem to have antidepressant properties. However, the standard treatment of depression remains the antidepressants.