The following is a two-part question concerning the disease known as
"psychotic depression."

(1) Who are the top five researchers and/or treating doctors in the
United States for the condition psychotic depression?

(2) What is the state-of-the-art protocol for treating psychotic
depression--in other words, what currently-used or experimental drug
regimes produce the best patient outcomes?

Please note: I do NOT want the following kinds of information:
(a) Information on "depression"--"psychotic depression" is a distinct
disorder requiring different treatment.
(b) Any information promulgated by drug companies on promotional
websites.

Specifically, too many treating psychiatrists are ill-informed of the
distinction in causes and treatment between depression and psychotic
depression, and so I am seeking, as noted above, either (1) a highly
specialized practitioner, or (2) highly specialized information to
convey to a less specialized practitioner.

Many thanks in advance for your assistance.

Hi there

1.	The top three US researchers into psychotic depression at present
are - Professor Charles Battista, MD, Professor Alan Schatzberg, MD,
and Joe Belanoff MD, all of Stanford University Medical Center.

Because of this triumvirate's stunningly successful recent research
(see 2), it is hard to look beyond them. After all, all previous
research into combating the illness resulted in treatments that
improved the condition slowly, or not at all.

However, W. Coryell, author of 'Psychotic Depression' in the Journal
of Clinical Psychiatry, is bound to have an abundance of knowledge on
the said topic.

Documentation of some previous research can be seen at:

http://www.biopsychiatry.com/olanzapine.htm
http://www.biopsychiatry.com/psychoticdepression.htm


2.	The study that the Stanford trio undertook involved using the drug
mifepristone, also known as RU-486, to combat psychotic depression.
It's a controversial drug, initially developed to induce abortion.
They found that after a week, patients who'd been suffering the
illness for years had shown a marked improvement. The success rates
for the drug, taken in pill form, were similar to success rates for
ECT (electro-convulsive treatment). The drug was more effective than
previous substances used.



For a full report on the findings please surf to:

http://mednews.stanford.edu/news_releases_html/2002/augreleases/mifepristone.html

or

http://www.bizjournals.com/sanjose/stories/2002/07/29/daily58.html


This avenue is still being fully explored. Presently clinicians like
to combine modern antidepressants with novel antipsychotics (the newer
drugs seem to have fewer side effects).

For a list of drugs, contraindicates and side effects please go to:

http://www.psychiatrymatters.com 

You then need to register (free). Then click on 'Current Diagnosis And
Treatment', then 'P to R'. Psychotic Depression is listed near the
bottom.
The section 'Pharmological Treatment' gives a full rundown of all the
modern drugs.

Hope this helps

If you need clarification, don't hesitate!

sim-ga


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