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Depression with psychotic features

Schizophrenia and Schizoaffective Disorder. Cross sectionally, it is often difficult to distinguish major depression with psychotic features from the schizophrenia spectrum disorders. There are theoretically qualitative differences in the psychosis that may help to make the distinction. Psychosis in the context of a mood disorder tends to be manifested by persecutory and nihilistic themes, but schizophrenia is more often characterized by paranoia and disorganization. However,... [Pg.45]

Another subgrouping of patients with depression who have a differential pharmacological response are those diagnosed with depression with psychotic features, previously referred to as psychotic depression. These patients generally do not respond well to antidepressant therapy alone but... [Pg.42]

One of the more methodologically rigorous studies on the utility of TCA/antipsychotic combinations in treating PMD was completed by Spiker et al. [1985). In this study, 54 patients who met criteria for depression with psychotic features on the Schedule for Affective Disorders and Schizophrenia [Endicott and Spitzer 1978) and by Research Diagnostic Criteria [Spitzer et al. 1985) were randomly selected to treatment with amitriptyline alone, perphenazine alone, or the combination of two drugs. After a 7-day placebo washout, patients were treated for 35 days with doses averaging approximately 50 mg/day of perphenazine and approximately 200 mg/day of ami-... [Pg.308]

To date, only one study has been completed with an antidepressant other than a TCA combined with an antipsychotic in the treatment of PMD. Rothschild and colleagues (1993) investigated the efficacy of fluoxetine and perphenazine in the treatment of PMD and found that approximately 73% of 30 patients who met DSM-III-R (American Psychiatric Association 1987) criteria for major depression with psychotic features had at least a 50% reduction on their Hamilton Rating Scale for Depression scores over 5 weeks. Furthermore, the combination of fluoxetine and perphenazine appeared to be better tolerated than the combination of TCAs with antipsychotics. Although there is no evidence that monotherapy with an antidepressant other than amoxapine is efficacious, the combination therapy with many antidepressants other than the TCAs may prove useful. [Pg.309]

Depression with psychotic features Antidepressant+antipsychotic, or ECT avoid bupropion... [Pg.17]

Because it can be difficult to distinguish a severe, apathetic depression from a patient with catatonic features, an augmenting antidepressant should be considered. These agents may also help a post-psychotic depression, suggesting the importance of identifying subgroups that might benefit from this approach. This combination is also much more effective than antidepressant monotherapy in depression with psychotic features (see also Chapter 6 and Chapter 7). [Pg.78]

Paxil is probably especially punishing in regard to causing both acute adverse effects and withdrawal. In a double-blind study, Zanardi et al. (1996) administered Zoloft and Paxil to inpatients diagnosed with depression with psychotic features. Within 2 weeks of starting treatment, 41% of the Paxil patients dropped out because of unpleasant side effects... [Pg.185]

A combination of olanzapine and fluoxetine was used in two randomized, double-blind simultaneous 8-week trials in 249 patients with major depression with psychotic features (trial 1 n = 124, mean age 41 years, 52% women trial 2 n = 125, mean age, 41 years, 50% women), which have been jointly published (69). This multicenter study was completed by 51 subjects in trial 1 (41%) and 59 subjects in trial 2 (47%). Altogether, there were no significant differences in the rates of discontinuation due to adverse events among the different treatment groups placebo (n = 100), monotherapy with olanzapine 5-20 mg/day (n = 101), and olanzapine 5-20 mg/day plus fluoxetine 20-80 mg/day (n = 48). Dropout percentages were 59% in trial 1 (similarly distributed in the three groups) and 53% in trial 2 (ranging from 40% of dropouts... [Pg.306]

Rothschild AJ, Williamson DJ, Tohen MF, Schatzberg A, Andersen SW, Van Campen LE, Sanger TM, Tollefson GD. A double-blind, randomized study of olanzapine and olanzapine/fluoxetine combination for major depression with psychotic features. J Clin Psychopharmacol 2004 19 365-73. [Pg.324]

Several subtypes of depression require specific treatment strategies that go beyond a simple course of conventional antidepressant therapy (these subtypes include bipolar depression, major depression with psychotic features, seasonal depression, atypical depression, comorbid anxiety disorder, comorbid substance abuse, double depression [major depression... [Pg.56]

Depression with psychotic features Delusions Hallucinations Catatonic features... [Pg.114]

Patients often have guilt feelings that are unrealistic, and these may reach delusional proportions. Patients may feel that they deserve punishment and may view their present illness as a punishment. A patient suffering from major depression with psychotic features may hear voices (auditory hallucinations) saying that he or she is a bad person and that he or she should commit suicide. Depression with psychotic features may require hospitalization, especially if the patient becomes a danger to self or others. [Pg.1237]

It is indicated in the treatment of depressive episodes associated with bipolar disorder. A combination of an antipsychotic drug and an antidepressant may be useful in some cases, especially in depressed psychotic patients, or in cases of agitated major depression with psychotic features. The first combination antipsychotic/antidepressant (olanza-pine/fluoxetine Symbyax) was recently FDA approved in the United States for treatment of depressive episodes associated with bipolar disorder. However, antidepressants and stimulants are unlikely to reduce apathy and withdrawal in schizophrenia, and they may induce clinical worsening in some cases. Adjunctive addition of lithium or an antimanic anticonvulsant, such as carbamazepine, may add benefit in some psychotic patients with prominent affective, aggressive, or resistant symptoms. [Pg.513]

The psychotic disorders include schizophrenia, the manic phase of bipolar (manic-depressive) illness, acute idiopathic psychotic illnesses, and other conditions marked by severe agitation. All exhibit major disturbances in reasoning, often with delusions and hallucinations. Several classes of drugs are effective for symptomatic treatment. Antipsychotic agents also are useful alternatives to electroconvulsive therapy (ECT) in severe depression with psychotic features, and sometimes are used in the management of patients with psychotic disorders associated with delirium or dementia or induced by other agents (e.g., stimulants or L-DOPA). [Pg.299]

Schizoaffective and mood disorder exclusion Schizoaffective disorder and mood disorder with psychotic features have been ruled out because either (1) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms or (2) if mood episodes have occurred during active-phase symptoms, their total duration has been brief relative to the duration of the active and residual periods. [Pg.552]

Mood Disorder with Psychotic Features. One subtype of major depression and many episodes of mania are associated with psychotic symptoms. Like schizophrenia, the most prominent psychotic symptoms of psychotic depression or mania are delusions and auditory hallucinations. Unless a longitudinal history is available, it is often difficult to distinguish schizophrenia from a psychotic mood disorder. [Pg.105]

A retrospective study of 52 delusionally depressed patients suggested that there may be various subgroups bipolar, early onset unipolar and possibly unipolar, late onset (12). As with previous reports, there was a remarkably high rate of psychotic relapse in those patients who manifested psychotic symptoms at the index admission (i.e., depression or mania with psychotic features). Moreover, psychotic features were more common in bipolar than in unipolar depression. [Pg.104]

McElroy and her coworkers (109) surveyed the response of 85 consecutive patients, including 14 bipolar patients with psychotic features, who received clozapine for 6 weeks. The response rates of the schizoaffective patients (both bipolar and depressed subtypes), as well as those with bipolar disorders with psychotic features, were excellent (i.e., almost 90%) and substantially better than the response rate for the pure schizophrenic group (i.e., 46%). [Pg.209]

Lyketsos and colleagues (485) have reported a dramatic, sustained increase in depressive symptoms as early as 18 months before the clinical diagnosis of AIDS. Mood disturbance, primarily depression, can range from mild adjustment phenomena to a major depressive episode with psychotic features. Depression in this group can be categorized as... [Pg.301]

Mania, depression, and cognitive disorders like Alzheimer s disease may or may not be associated with psychotic features. True or False. [Pg.628]

A patient taking diltiazem developed the signs and symptoms of mania (114) and another developed mania with psychotic features (115). There have also been reports that nifedipine can cause agitation, tremor, belligerence, and depression (116), and that verapamil can cause toxic delirium (117). Nightmares and visual hallucinations have been associated with nifedipine (118). Depression has been reported as a possible adverse effect of nifedipine (119). [Pg.656]

Use in combination with lithium or valproate for the acute treatment of mania or mixed states (primarily with psychotic features) for bipolar I disorder. Only olanzapine is FDA approved at this time for maintenance treatment and only quetiapine for bipolar depression. [Pg.769]

In all of these trials, the Hamilton Rating Scale for Depression (HAMD) [260], a well-validated and widely accepted observer rating scale for the assessment of the severity of depressive disorders, was employed as the primary outcome variable (if specified) or as the first of several outcome variables (if no distinction between primary and concomitant variables was made). As patients with psychotic features were excluded from most of the trials, the 17-item version was predominantly used. [Pg.702]

Electroconvulsive therapy (ECT) is probably the most effective treatment for major depressive disorder (MDD) with psychotic features, with average response rates of 70-90%, compared with only about 40% for regular antidepressant medications. The response rates for MDD without psychosis are comparable between regular medications and ECT (about 70-75%). ECT is usually given to patients whose condition is refractory to or who are intolerant of antidepressant medication. [Pg.157]

Major depressive disorder (MDD) with psychotic features... [Pg.209]


See other pages where Depression with psychotic features is mentioned: [Pg.578]    [Pg.40]    [Pg.292]    [Pg.57]    [Pg.107]    [Pg.237]    [Pg.735]    [Pg.312]    [Pg.578]    [Pg.40]    [Pg.292]    [Pg.57]    [Pg.107]    [Pg.237]    [Pg.735]    [Pg.312]    [Pg.553]    [Pg.782]    [Pg.49]    [Pg.162]    [Pg.167]    [Pg.174]    [Pg.174]    [Pg.195]    [Pg.239]    [Pg.866]    [Pg.69]    [Pg.188]    [Pg.320]    [Pg.217]   
See also in sourсe #XX -- [ Pg.57 ]




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Depression psychotic

Depressive disorders with psychotic features

Major depressive disorder with psychotic features

Psychotics

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