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mood:1-depression:psychotic [on September 10, 2018]
mood:1-depression:psychotic [on January 26, 2022]
psychdb [Treatment]
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 +====== Psychotic Depression ======
 +{{INLINETOC}} ​
 +===== Primer =====
 +**Psychotic Depression** (also known as **Major Depressive Disorder with psychotic features** in the DSM-5) is a subtype of [[mood:​1-depression:​home|depression]] characterized by psychosis (delusions, hallucinations) in addition to mood changes. It requires the treatment of the underlying mood disorder first to resolve the psychosis.
  
 +
 +
 +===== Treatment =====
 +<alert type="​info"​ icon="​fa fa-book fa-lg fa-fw">​
 +See also:
 +  * **[[https://​www.ncbi.nlm.nih.gov/​pubmed/​28445632|Bingham,​ K. S., Rothschild, A. J., Mulsant, B. H., Whyte, E. M., Meyers, B. S., Banerjee, S., ... & Flint, A. J. (2017). The Association of Baseline Suicidality With Treatment Outcome in Psychotic Depression. The Journal of clinical psychiatry, 78(8), 1149-1154.]]**
 +  * **[[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC3686458/​|Rothschild,​ A. J. (2013). Challenges in the treatment of major depressive disorder with psychotic features. Schizophrenia bulletin, 39(4), 787-796.]]**
 +</​alert>​
 +
 +  * For psychotic depression, treatment with an antidepressant-antipsychotic combination is better than treating with an antidepressant or antipsychotic alone.[([[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC4994790/​|Kennedy,​ S. H., Lam, R. W., McIntyre, R. S., Tourjman, S. V., Bhat, V., Blier, P., ... & CANMAT Depression Work Group. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder: section 3. Pharmacological treatments. The Canadian Journal of Psychiatry, 61(9), 540-560.]])] For example, treatment with olanzapine plus sertraline has been shown to be efficacious.[([[https://​www.ncbi.nlm.nih.gov/​pmc/​articles/​PMC2840400/​|Meyers,​ B. S., Flint, A. J., Rothschild, A. J., Mulsant, B. H., Whyte, E. M., Peasley-Miklus,​ C., ... & Heo, M. (2009). A double-blind randomized controlled trial of olanzapine plus sertraline vs olanzapine plus placebo for psychotic depression: the study of pharmacotherapy of psychotic depression (STOP-PD). Archives of general psychiatry, 66(8), 838-847.]])] It remains uncertain how long one should remain on this combination treatment once the psychotic depressive episode has remitted.
 +===== Resources =====
 +  * [[https://​www.ncbi.nlm.nih.gov/​pubmed/​28709381|Perera,​ J. K., Rosenblat, J. D., & Flint, A. J. (2017). Dementia with Lewy bodies presenting as psychotic depression. Australian & New Zealand Journal of Psychiatry, 51(11), 1160-1161.]]