This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This is a double-blind placebo controlled 12-week study of the acute treatment of psychotic depression. Subjects who acheive partial remission enter a stabilization phase augmentation treatment trial on an outpatient basis. The primary objectives of this study are: -To compare the efficacy of two pharmacotherapies for psychotic depression: high dose SSRI (sertraline 150-200mg/day) combined with an atypical antipsychotic (olanzapine 10-20 mg/day) versus the atypical anthipychotic plus placebo. (olanzapine 10-20mg/day). -To determine whether older patients have lower remission rates and poorer tolerability to the pharmacotherapy conditions. In addition, changes in glucose and lipid levels will be used to determine whether old age influences the metabolic effects of olanzapine. Setraline and Olansapine levels will be obtained to assess their contribution to outcomes.
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