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The most effective acute treatment for patients with psychotic depression is an antidepressant plus an antipsychotic, but after response, should treatment be continued? In a trial involving 126 patients with psychotic depression who had achieved remission of psychosis and full or near remission of depressive symptoms after 12 weeks of treatment with sertraline (median dose, 150 mg daily) plus olanzapine (median dose, 15 mg daily) and continued to be in remission for 8 more weeks, investigators randomized the participants to sertraline plus olanzapine or sertraline plus placebo for the next 36 weeks.
Relapse was more than twice as likely in the sertraline-placebo group than the sertraline-olanzapine group (55% vs. 20%). Most relapses occurred…