title: New approaches to managing psychotic depression.
abstract: Major depression with psychotic features, while fairly common, is frequently misdiagnosed. Symptoms seen in these patients are those of an overall severe depressive disorder with psychomotor impairment (retardation or agitation), guilt, suicidal preoccupation, and neuropsychological impairment. A number of biological characteristics and behavioral symptoms are specific to patients suffering from psychotic depression and differ significantly from those of nonpsychotic depression. Psychotic depression is seen in patients of all ages, and it has a high short-term morbidity and risk of suicide. Data support the use of antipsychotics in combination with antidepressants for major depression with psychotic features, but other treatments may have as great or greater efficacy for the disorder. This article focuses on recognizing the features of psychotic depression, the success of current treatment options, and new treatments under investigation.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, CA 94305-5717, USA. afschatz@stanford.edu
authors.forename: Alan F
authors.initials: AF
authors.lastname: Schatzberg
mesh_terms: D000341:Affective Disorders, Psychotic / Q000175:diagnosis* / Q000188:drug therapy*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D004565:Electroconvulsive Therapy; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000627:therapeutic use; D015735:Mifepristone / Q000627:therapeutic use; D000077152:Olanzapine; D010890:Pirenzepine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011965:Receptors, Glucocorticoid / Q000037:antagonists & inhibitors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D011965:Receptors, Glucocorticoid; D005473:Fluoxetine; D001569:Benzodiazepines; D015735:Mifepristone; D010890:Pirenzepine; D008094:Lithium; D000077152:Olanzapine