PHARMACOTHERAPY OF DELUSIONAL DEPRESSION - EXPERIENCE WITH COMBINATIONS OF ANTIDEPRESSANTS WITH THE NEUROLEPTICS ZOTEPINE AND HALOPERIDOL

The combination of an antidepressant with a neuroleptic is standard ph armacotherapy for delusional depression today. The neuroleptics used a re rarely specified: occasionally haloperidol or perphenazine are ment ioned. In two different open-treatment studies, consecutively admitted delusional depressed inpatients received a butyrophenone [haloperidol , bromperidol, approximately 10 mg/day (n = 16)] or zotepine [150-200 mg/day (n = 15)] as a neuroleptic in combination with a tri- or tetrac yclic antidepressant (amitriptyline, maprotiline, 150 mg/day). There w as a significant improvement in both groups in the sum score of the Ha milton depression scale (24-item version), in a subscore of so-called delusional items (items 2, 17, 19, 20, 23, and 24 together), in the su bscore of remaining items and also in most single items such as mood, inhibition, agitation, feelings of guilt or hopelessness.