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Data on adverse effects of antipsychotic drugs on brain structure are conflicting. To address this issue, investigators examined MRI data from a randomized, controlled, two-phase trial (NEJM JW Psychiatry Oct 2019 and JAMA 2019; 322:622) that examined the effectiveness of an antipsychotic–antidepressant combination to prevent relapse of psychotic depression.
Patients were openly treated with sertraline plus olanzapine, and those who achieved remission of psychosis and remission or near-remission of depression were then randomized to receive sertraline plus olanzapine or placebo for 36 weeks. The current study involved MRIs from 72 patients at the start of the randomized phase and at the end of the study.
Compared with placebo, olanzapine was …