Evaluation of newer treatment interventions for psychotic depression

Abstract

Psychotic depression is characterized by greater severity, higher rate of recurrence, greater incapacitation, more frequent hospitalization, and longer episodes than nonpsychotic depression. The use of combined tricyclic antidepressants (TCAs) and neuroleptic therapy, as well as electroconvulsive therapy, has proven effectiveness in the treatment of psychotic depression. Although it is limited, evidence for efficacy of selective serontonin reuptake inhibitors both alone and in combination with antipsychotics in psychotic depression suggests that these strategies may provide a desirable alternative to the traditional TCA- neuroleptic therapy. These treatments, in addition to the continual introduction of new psychotropic agents suggest that the prospect of future research in this area is promising.

Quality Indicators for the Care of Depression in Vulnerable Elders

“…Immediate evaluation for suicidal ideation and psychotic features is needed, because these may herald a poor prognosis 34 and can be acted on in effective ways. [35][36][37] Elicitation and documentation of information about suicidal ideation or intention and psychotic features is recommended in numerous guidelines. 1,23,[30][31][32] Suicidal Ideation 6.…”

Olanzapine in the treatment of depression with psychotic features: A prospective open-label study

“…Specific differences have been described for the ventricle-to-brain ratio, and higher heredity and poorer prognosis have been reported. Psychotic depressive syndromes are also characterized by more severe affective symptoms, higher rates of relapse and hospitalization, more treatment-refractory courses and longer episodes than non-psychotic syndromes [1,12,13]. Among the differences in symptom patterns are more anxiety, less insight into the illness, a higher incidence of guilt feelings, more ruminative and referential ideas and stronger agitation with a lower overall treatment response rate than in nondelusional depressive patients [1,12,14].…”