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The combination of a tricyclic antidepressant with a neuroleptic (usually perphenazine) is well established as superior to either drug alone in treating depression accompanied by delusions, with or without hallucinations (i.e., delusional or psychotic depression). To determine the efficacy of combining newer antidepressants with antipsychotic drugs, researchers conducted a 12-week, double-blind, randomized study in 259 patients with delusions and moderately severe depression (mean baseline Hamilton Rating Scale for Depression [HRSD] score, 30). The patients began taking olanzapine (mean dose, 15 mg/day) and were randomized to receive adjunctive sertraline (mean dose, 169 mg/day) or placebo.
Final HRSD scores were significantly lower with com…