[Psychotic depression: therapy, prevention, side effects, patient information and prognosis]

Depressive syndromes are common disorders. They can be severely disabling and, too often, may lead to suicide. Pharmacological attempts to relieve depression have a long history. However, it was the development of monoaminooxidase inhibitors and tricyclic antidepressants which first provided truly effective antidepressants for medical use. Antidepressants, coupled with supportive therapy can usually accelerate improvement, diminish the intensity of symptoms and reduce the danger of suicide. The lithium salts lead to a better prognosis of many patients suffering from psychotic depression and promote social adjustment and occupational rehabilitation. Especially the tricyclic antidepressants are anything but ideal. They are slow-acting, have side effects, can cause fatal overdoses, and do not help every patient. In the course of an ideal antidepressant therapy a more immediate onset of drug action could decrease the risk of suicide and diminish the severe life disruptions that long illnesses can cause. Less toxic medications could also decrease their utilization for suicide attempts.