A 60 year male is brought by his wife. He thinks that he had committed sins all through his life. He is very much depressed and has considered committing suicide but has not through hot do go about it. He had also attached sessions with a spiritual guru. He is not convinced by his wife that he has lead a pious life. He does not want to hear anything on the contrary. How will you treat him?

A i.e. Antipsychotic + Anti depressant The patient is presenting with features of depression, hypochondrial preoccupation & delusional guilt suggesting the diagnosis of depression with psychotic features (i.e. psychotic depression). It should be managed with a combination of antipsychotic (SNRIs or TCA rather than SSRI) and antidepressantQ. ECT is an alternative perhaps more effective than pharmacotherapy.