[2] Common themes of mood congruent delusions include guilt, persecution, punishment, personal inadequacy, or disease.

[2] Hallucinations can be auditory, visual, olfactory (smell), or tactile (touch), and are congruent with delusional material.

[17] In the context of psychotic depression, the following are the most well-studied antidepressant/antipsychotic combinations: First-generation Second-generation There is insufficient evidence to determine if treatment with an antidepressant alone is effective.

[27] In modern practice of ECT a therapeutic clonic seizure is induced by electric current via electrodes placed on a person under general anesthesia.

[28] ECT carries the risk of temporary cognitive deficits (e.g., confusion, memory problems), in addition to the burden of repeated exposures to general anesthesia.

[29] Efforts are made to find a treatment which targets the proposed specific underlying pathophysiology of psychotic depression.

A promising candidate was mifepristone,[30] which by competitively blocking certain neuro-receptors, renders cortisol less able to directly act on the brain and was thought to therefore correct an overactive HPA axis.

However, a Phase III clinical trial, which investigated the use of mifepristone in PMD, was terminated early due to lack of efficacy.

TMS involves the administration of a focused electromagnetic field to the cortex to stimulate specific nerve pathways.