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Alexander H. Glassman, MD; Steven P. Roose, MD
Department of Psychiatry College of Physicians and Surgeons of Columbia University New York, NY 10032

Arch Gen Psychiatry. 1986;43(10):1014.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Howarth and Grace¹ have suggested that a number of reports indicate that tricyclic antidepressants (TCAs) might work effectively in the treatment of delusional depression, and they have cited three reports.^2-4 Our reading is that only the 1978 reanalysis by Quitkin et al² of Klein's 1959 data might suggest that delusional depressive patients respond to TCAs at a rate equal to that of nondelusional patients. The other two cited studies actually show a lower rate of response among delusional compared with nondelusional patients.

The study by De Carolis et al³ is particularly striking because of the sample size (181 delusional patients with a 40% response rate vs 256 nondelusional patients with a 68% response rate; P<.001). Simpson et al⁴ clearly noted that "depressed patients who were deluded tended to have a higher failure rate than those who were not deluded." Both studies' conclusions . . . [Full Text PDF of this Article]

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