Depression with Psychotic Symptoms Difficult to Treat

By BrainPhysics Staff, Tue, December 07, 2010

A study shows that people who have depression with psychotic-like symptoms may not respond well to antidepressants:

"People with depression who also have psychotic-like symptoms, such as hearing voices or believing others are plotting against them, are less likely to respond to antidepressants, a new study finds.

It also found that bipolar disorder does not appear to be associated with treatment resistance in patients with depression, a finding that challenges the common theory that some cases of difficult-to-treat depression are actually unrecognized bipolar disorder, the researchers added.

They conducted the study to assess the link between bipolar disorder and treatment outcomes among 4,041 patients with depression. The patients first received the antidepressant citalopram (Celexa), followed by up to three next-step treatments, depending on their responses.
At the start of the study, 1,198 (30 percent) of the patients said they had experienced at least one psychotic symptom -- such as believing they had special powers or were being controlled or plotted against -- in the previous six months. These patients were significantly less likely to respond to treatment.
In addition, 1,524 patients (38.1 percent) said they had experienced at least one symptom of bipolar disorder in the previous six months. Of those symptoms, irritability was associated with poor treatment outcomes."

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