Depression, Delusions, and Drug Response

Depressed patients with delusions were found to be markedly unresponsive to tricyclic drug therapy during an ongoing study of depressed patients. After four weeks of administration of imipramine hydrochloride, only 3 of 13 delusional depressed patients had responded to the drug, but 14 of 21 nondelusional depressed patients had responded. The authors conclude on the basis of these data and those of other researchers that delusional depressed patients should not be treated with tricyclic antidepressants and that current research with depressed patients should be reevaluated in the light of this finding.