Depression with anxiety associated with chronic physical disease is treated with which combination?

• A. Perphenazine + Amitriptyline
• B. Chlorpromazine + Haloperidol
• C. Trifluoperazine + Fluoxetine
• D. Haloperidol + L-DOPA

Answer: (A)

In depression with anxiety that accompanies chronic physical illness, you want a treatment that tackles mood, anxiety, sleep, and somatic symptoms like pain. Amitriptyline, a tricyclic antidepressant, provides robust mood improvement and also helps with sleep and pain, which is particularly helpful in chronic illness. Adding a low-dose typical antipsychotic like perphenazine adds calming, anti-anxiety effect and can enhance overall symptom relief, especially when agitation or insomnia is prominent. This combination therefore addresses the multiple domains seen in psychosomatic depression—mood, anxiety, and somatic symptoms—in a single strategy. Other options either lack a true antidepressant effect, rely on antipsychotics alone, or pair drugs not best suited for the combined mood, anxiety, and somatic symptom profile of chronic illness.