help

I have a 56 yr old patient suffering from psychotic depression. She has been on/off several meds, inpatient and outpatient psychiatric centers, etc and is progressing fair at best.

She is currently taking 1/2 mg of risperdal, 20 mg of prozac, 4 mg of ativan and now being placed on artane.

She responds poorly to therapy at this point.

She is paranoid, prefers to hide in bed most of the day, flat affect and timid.

She wishes to return to teaching and her normal lifestlye and can't.

She denies current suicidal tendency, but has reported this in the past as well as being delusional.

Her MD recommended ECT but she's scared of memory loss etc being a teacher.

There is a research study at Stanford underway for use of mifepristone (morning after pill) to reset her HPA axis in the same way ECT is being used for currently.

Any thoughts?