Psychotic depression is classified as a clinical subtype of major
depressive disorder. The combination of an antidepressant with an
antipsychotic agent has been demonstrated to be efficacious for the
treatment of psychotic depression. However, in elderly patients with
psychotic depression, little information is available on the efficacy of
such combinations. Therefore, we have evaluated combination treatment
for 5 weeks with amisulpride and antidepressants in non-demented elderly
patients with psychotic depression. Eleven patients were treated with
either citalopram 20-40 mg/day (n = 5) or mirtazapine 30-60 mg/day (n =
6), and amisulpride 75-100 mg/day for 5 weeks. Clinical status was
evaluated at baseline and after 3 and 5 weeks using the Brief
Psychiatric Rating Scale (BPRS), the Hamilton Depression Rating Scale-17
items (HDRS) and the Clinical Global Impression Scale (CGI-S). In 5 of
the 11 patients there was remission of depression, while in another 5
patients there was partial remission of depression and in one patient
there was no remission. Finally, there was resolution of psychotic
symptoms in all the patients involved. One patient developed tremor and
rigidity but insisted on continuing with the drug since her
psychopathology has improved considerably after the addition of
amisulpride to antidepressant treatment. In conclusion, some of the
elderly patients with psychotic depression may benefit from the
combination of amisulpride and antidepressant pharmacotherapy. (C) 2008
Published by Elsevier Inc