|
Major depressive disorder with psychotic features is fairly common but difficult to be diagnosed and managed. The patients with psychotic depression have psychomotor impairments, guilt, suicidal ideation or attempt, and neuropsychological impairments. Compared with non-psychotically depressed patients, these patients exhibit more frequent relapses and recurrences and have increased use of medical services, greater disability, more social and occupational impairments, and a poorer clinical course. They demonstrate distinct biological abnormalities in various studies. Several studies support a relationship between bipolar affective disorder and psychotic depression. The combination of an antidepressant and an antipsychotic or electroconvulsive therapy may be most efficacious treatments for psychotic depression. The combination of a selective serotonin reuptake inhibitor and an atypical antipsychotic may have particular relevance for the treatment of psychotic depression because of the potential for decreased risk of side effects, as well as possible antidepressant properties of an atypical antipsychotic itself. Additionally, glucocorticoid antagonist may have as good or better efficacy for the disorder. This article focused on recognizing the characteristics of psychotic depression, favorable treatment options, and new treatments under investigation.
|