In this cross-sectional and multi-site study, the antipsychotics use and the associated factors are studied among non-psychotic major depressive disorder (MDD).

• Among 1,503 eligible MDD patients included after 8–12 weeks of antidepressant treatment, the most commonly used adjunct to antidepressants was quetiapine (43.4%), followed by olanzapine (38.8%).

• Commonly antipsychotics were used in combination with escitalopram (23.1%), venlafaxine (21.7%), sertraline (14.8%).

• Overall non-psychotic MDD patients are commonly administered antipsychotics.

• In non-psychotic depressed patients, following were the factors influencing the combination of antipsychotics: service setting, comorbidity of physical illness, PHQ level, SDS level and antidepressants co-treatment.