• This study, a retrospective review of clinical experience, investigated response to tricyclic antidepressants in a group of 34 depressives with delusions and a group of 22 depressives without delusions. There was no difference between the groups in terms of their age, sex, or dosage of tricyclic antidepressant. The pattern of when patients left tricyclic therapy for electroconvulsive therapy was similar in both groups. For those responding to tricyclics, the nondelusional group responded within the first three weeks of therapy, whereas for the delusional group the responders were more spread throughout the nine weeks. Delusional depressives were more likely to respond to tricyclic antidepressants than were nondelusional depressives.