The Pharmacological Treatment of Delusional Depression

Spiker, Duane G.; Perel, James M.; Hanin, Israel; Dealy, Robert S.; Griffin, Suzanne; Soloff, Paul H.; Weiss, Jane Cofsky

doi:10.1097/00004714-198612000-00003

Cited by 95 publications

(115 citation statements)

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“…One of the earliest treatment studies for psychotic depression (not specific to older adults) resulted in the recommendation that psychotic depression should be treated with amitriptyline and perphenazine [64]. A subsequent randomized study demonstrated that the addition of a moderate dose of perphenazine to nortriptyline was well tolerated but did not improve efficacy [65].…”

Section: Treatment Of Psychotic Depressionmentioning

confidence: 99%

Evidence-Based Pharmacologic Interventions for Geriatric Depression

Shanmugham

Karp

Drayer

et al. 2005

Psychiatric Clinics of North America

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Section: Treatment Of Psychotic Depressionmentioning

confidence: 99%

Evidence-Based Pharmacologic Interventions for Geriatric Depression

Shanmugham

Karp

Drayer

et al. 2005

Psychiatric Clinics of North America

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“…There are considerable data suggesting that PMD is a distinct syndrome from nonpsychotic major depression (NPMD), as evidenced by significant differences on a number of different dimensions: neuropsychological testing Fleming et al, 2004;Hill et al, 2004), response to treatment (Spiker et al, 1985), and morbidity and mortality (Rothschild, 2003;Vythilingam et al, 2003). PMD patients also show a number of biological characteristics that are distinct from NPMD patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Biological Effects of Mifepristone Treatment for Psychotic Depression

Flores

Kenna

Keller

et al. 2005

Neuropsychopharmacol

188

106

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Psychotic major depression (PMD) is found to be a relatively common psychiatric condition that affects up to nearly 20% of patients with major depression. Previous studies by our group have shown rapid reversal of psychotic symptoms in some PMD patients treated with mifepristone, in addition to restoring a more normal afternoon cortisol release. The rationale for treating patients with PMD with a glucocorticosteroid receptor antagonist is further discussed. In total, 30 patients with PMD were treated with either 600 mg/day mifepristone or placebo for 8 days in a randomized double-blind manner. The Hamilton Depression Rating Scale (HDRS) and the Brief Psychiatric Rating Scale (BPRS) were administered at baseline and again after 8 days of treatment. Cortisol and ACTH were measured hourly from 1800 to 0900 at baseline and after 8 days of treatment. Significantly, more patients in the mifepristone group (seven of 15) showed a 50% or greater decline on the BPRS positive symptom subscale, an index of psychotic symptoms, as compared to the placebo group (two of 15). Patients who received mifepristone had lower HDRS and BPRS scores at study completion compared to those who received placebo, but these differences were not statistically significant. In addition, mifepristone significantly elevated cortisol and ACTH levels and steepened ascending slopes from 1800 to 0100 and from 0100 to 0900 as compared to placebo. Clinical and biological effects of mifepristone were comparable among males and females. Age was found to significantly and positively correlate with changes in cortisol and ACTH. These results suggest that short-term use of mifepristone may be effective in the treatment of PMD and may reregulate the HPA axis. Additional blinded studies are warranted.

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“…Spiker et al, (1985) carried out one of the first randomized, double-blind prospective studies. Patients were randomized to amitriptyline monotherapy, perphenazine monotherapy, or combined amitriptyline plus perphenazine over a 5 week period; the response rates were 41% (7/17), 19% (3/16), and 78% (14/18) respectively.…”

Section: Treatment Straegies For Pmdmentioning

confidence: 99%

An Update on Psychotic Depression

Matthews¹

2012

Mental Illnesses - Understanding, Prediction and Control

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The Pharmacological Treatment of Delusional Depression

Cited by 95 publications

References 0 publications

Evidence-Based Pharmacologic Interventions for Geriatric Depression

Evidence-Based Pharmacologic Interventions for Geriatric Depression

Clinical and Biological Effects of Mifepristone Treatment for Psychotic Depression

An Update on Psychotic Depression

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