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Psychotic depression often is more severe than nonpsychotic depression and usually requires combination therapy with an antidepressant and an antipsychotic drug. Scientists have hypothesized that the marked hyperactivity of the hypothalamic-pituitary-adrenal (HPA) axis that is typical in psychotic depression is associated with hyperactive signaling of the glucocorticoid receptor, with downstream effects on dopamine and glutamate signaling. In an industry-sponsored analysis, researchers analyzed five double-blind, placebo-controlled, manufacturer-funded comparisons of mifepristone, a glucocorticoid receptor (GR) antagonist, in an intent-to-treat sample of 1388 patients with psychotic depression who were also prescribed antidepressant medicat…