Psychotic depression is frequent among hospitalized patients diagnosed with major depression. Patients diagnosed with this type of depression display a number of specific characteristics. They have a higher risk of suicidal behaviour, they have a prolonged and more severe clinical picture and subsequently they have an increased risk of relapse. Studies show that monotherapy with antidepressants is more effective than antipsychotic monotherapy. Electroconvulsive therapy remains the most effective treatment, while tricyclic antidepressants in monotherapy are also effective. An antipsychotic drug can be added if no effect of monotherapeutic antidepressant treatment is observed within two to four weeks.