In this retrospective study the authors determined the efficacy of
lithium added to a combined antipsychotic-antidepressant drug regimen in 21
psychotically depressed patients who had been refractory to combined drug
treatment. Response to lithium was then compared with response rates of 15
patients to ECT, the established treatment for nonresponsive delusional
depression. Lithium was effective in eight of nine patients with bipolar
depression but in only three of 12 patients with unipolar depression; ECT
was effective in nine of 15 patients with unipolar depression. Lithium
augmentation appeared to be a realistic treatment alternative for
refractory bipolar patients but was disappointing in unipolar patients.Abstract Teaser