Clinical features: Depressive psychosis or schizophrenic disorder is a serious mental illness that involves changes of mood for duration of six months or more. It can be divided into two forms; biporal affective disorder (Manic depression) and major depression without manic episodes. It includes insomnia characterized by early waking after 2-3 hours of sleep, variation of mood, ideas of guilt, unworthiness and self-blame often delusional in intensity.
In manic depressive psychosis, patients can suffer from abnormal elation and hypersensitivity in addition to attacks or depression.
Treatment Guidelines
Drug of choice |
Amitriptyline 50-75 mg at bed time and increase gradually to a maximum of 150 - 200 mg. Maintenance dose for 3-6 months 50 - 100 mg in 24 hours |
| |
OR |
| |
Imipramine 75 - 100 mg at night until neurosis is controlled. |
For manic attacks |
Haloperidol 3 - 5 mg I.M. and increase to 30 mg every 4-8 hours till acute attack is controlled. Then give by mouth 3-4.5 mg every 8 hours. |
