Response of psychotic and nonpsychotic depressed patients to tricyclic antidepressants.

The response to tricyclic antidepressants (TCAs) is studied in 75 of 121 depressed patients classified as psychotic or nonpsychotic subtypes by Research Diagnostic Criteria. Response was assessed by a clinical global evaluation scale. Of the 75 patients treated with TCAs, 40 (68%) of the nonpsychotic subtype responded in contrast to only 4 (25%) of the psychotic subtype. Adjusting for the effects of chronicity, sex, age, incapacity, agitation, retardation, endogenicity, and the unipolar-bipolar distinction as covariates, it was found that these variables failed to alter the differential response rate of the psychotic and nonpsychotic depressed groups. A literature review of 1054 patients revealed that 67% of the nonpsychotic depressed patients responded to TCAs compared with only 35% of the psychotic depressed patients.