Augmentation with Atomoxetine in Treatment-Resistant Depression with Psychotic Features

The selective norepinephrine reuptake inhibitor atomoxetine has recently been reported to be effective as an augmenting agent in treatment-resistant depression. We report on a patient with major depression with psychotic features and a history of severe treatment-resistance who responded to a trial of atomoxetine augmentation. Various adequate and experimental treatment trials (including electroconvulsive therapy [ECT]) had previously failed to effect response. Discontinuation of atomoxetine resulted in a severe relapse. The initial treatment response was achieved once more after reapplying atomoxetine. This case report is congruent with previous articles on successful atomoxetine augmentation. In addition, this is the first report on the compatibility of this treatment strategy with psychotic symptoms accompanying major depression.

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