We observed seven patients (five men and two women; mean age=36.7 years, SD=13.8, range=26–61) who met the DSM-IV criteria for a major depressive episode with psychotic features; six had major depressive disorder (four of these with a single episode and two with recurrent episodes), and one had bipolar I disorder. The essential psychotic features of these patients were auditory hallucinations and nihilistic, poverty, and persecutory delusions. Written informed consent was obtained from the subjects after complete description of the study. They were treated with citalopram, 20 mg/day p.o., and haloperidol, 4 mg/day p.o. The doses of haloperidol were increased to 5–9 mg/day in six patients with poor response during the first week, and the doses of citalopram were increased to 30–40 mg/day in five patients with poor response during the second week. Both the citalopram and haloperidol doses were increased in four patients. Two patients were being treated with mood stabilizers (lithium or carbamazepine) before entering the study. No other psychotropic drug was administered except triazolam (0.25–0.50 mg/day).