Delusional depression, comparing to non-delusional depression, is characterized by severe depressive symptoms, high risk of recurrence, long duration of depressive episode, and is refractory to the treatment with antidepressants alone, besides amoxapine, which has the antagonistic property to dopamine 2 receptor like an antipsychotic. The combination therapy of an antidepressant with an antipsychotic is a highly effective strategy as well as the electroconvulsive therapy(ECT). ECT tends to reveal higher therapeutic effects rather than the combination therapy. As to the combination therapy, lithium augmentation is clearly effective to the bipolar type. Atypical antipsychotics(clozapine, risperidone, olanzapine) have thymoleptic properties. They have been to reported to have therapeutic effects by monotherapy or combination with mood stabilizer(lithium). Thus, atypical antipsychotics are expected to be a new effective strategy for delusional depression.