Treatment of unipolar depression accompanied by delusions. ECT versus tricyclic antidepressant--antipsychotic combinations.

A retrospective chart study conducted to compare the effectiveness of ECT to tricyclic antidepressant--antipsychotic combination therapy in the treatment of psychotic major depressive disorder. A favorable treatment response occurred in 86% of the ECT-treated patients and 42% of the antidepressant--antipsychotic-treated patients. Depressive symptoms showed improvement in all ECT-treated patients but only 50% of the tricyclic antidepressant--antipsychotic-treated patients. It was concluded that a significantly better treatment response can be expected in delusional depressed patients if treated with ECT rather than a tricyclic antidepressant--antipsychotic drug combination.