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The question was submitted 21/07/2008

Subject: Psychotic Depreession and treatments

I would like to know if psychotic depression can be treated with ect therapy? What else besides tricylic and mood stablises can help this kind of depression and is treatable if so how long does treatment take?
Thank you

Answer from DepNet

Psychotic depression is defined as a severe form of depression in which an individual also experiences what are referred to as psychotic symptoms, such as hallucinations or delusions. Psychotic depression may be treated with a range of treatments, including medication (antidepressants plus antipsychotics) or with electroconvulsive therapy (ECT). In cases where an individual is treated with ECT, they are usually required to commence antidepressant medications to maintain their improvement after the ECT has finished.

Mood stabilisers (for example, lithium or sodium valproate) are used to augment or boost the effect of antidepressants if an individual has demonstrated a partial response to an antidepressant.

Treatment can be divided into acute and maintenance phases. The acute phase of treatment is aimed at treating the symptoms of depression, such as low mood and insomnia, and may take four to eight weeks for medication, and two to four weeks for ECT. The aim of the maintenance phase of treatment is to maintain the benefits of treatment: for individuals who have had a single episode of depression, it is usually recommended they take antidepressant medications for at least 12 months. For individuals with more than one episode of depression, the maintenance phase may be one to three years.

Psychological intervention (psychotherapy) can be useful for individuals with psychotic depression, especially after they have begun to improve, however, psychotherapy would not be considered first-line or stand-alone treatment for an individual with psychotic depression.

In terms of the treatment setting, individuals with psychotic depression are often treated in hospital settings, due to the severity of the condition and the risk of self-harm or neglect to self.

The answer was published on DepNet 22/07/2008