Treating psychotic depression in adults and young people

Psychotic depression is a psychiatric emergency. Refer the patient for urgent treatment by a psychiatrist, specialist centre or mental health team. For the management of acute behavioural disturbance associated with psychotic depression, see here.

Psychiatrists may use a combination of an antidepressant and an antipsychotic for psychotic depression. There is limited evidence to guide choice of antipsychotic—antipsychotics with evidence as augmenting agents for major depression (eg aripiprazole, brexpiprazole, olanzapine, quetiapine) or other antipsychotics can be used. Electroconvulsive therapy is an effective treatment for psychotic depression.