Psychotic depression | Seasonal affective disorder | Bipolar depression
Extrapolating from adult studies suggests the atypical antipsychotic
medications combined with SSRIs as the treatment of choice for depressed
youth who are psychotic (Hughes et al. 2007). Vague
or mild psychotic symptoms in a depressed youth may respond to antidepressants
alone. How long the antipsychotic should be continued after the
psychotic symptoms have improved is unclear, but the recommendation
is to slowly taper these medications, with the eventual goal of
keeping the child on monotherapy with an antidepressant. If the
child is going to be maintained for long periods of time on both
medications, side effects associated with the use of atypical antipsychotics
and possible interactions with the antidepressants need to be monitored.
Noncontrolled reports suggest that electroconvulsive therapy (ECT)
may be useful for depressed psychotic adolescents.