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Citalopram, but not interpersonal psychotherapy, improves major depression in people with coronary artery disease

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 Q Are citalopram or interpersonal psychotherapy more effective than placebo or clinical management for major depression in people with coronary artery disease?

METHODS

Embedded ImageDesign:

Randomised controlled 2×2 factorial trial.

Embedded ImageAllocation:

Concealed.

Embedded ImageBlinding:

Double blind for citalopram and placebo; single blind for interpersonal psychotherapy (IPT) or clinical management (assessors blind).

Embedded ImageFollow-up period:

Twelve weeks (treatment period only).

Embedded ImageSetting:

Nine academic centres, Canada; May 2002 to March 2006.

Embedded ImagePatients:

284 outpatients (⩾18 years old) with DSM-IV major depression for ⩾4 weeks, Hamilton Depression rating scale (HAM-D) score ⩾20, and established coronary artery disease (previous myocardial infarction or revascularisation; or angiographic evidence of ⩾50% stenosis in ⩾1 major coronary artery). Main exclusions: depression with psychotic features; bipolar disorder; substance abuse; serious suicidal risk; taking antidepressants, anticonvulsants, lithium, or undergoing psychotherapy; previous non-response to citalopram or IPT; ⩾2 unsuccessful treatments for current depressive episode; previous early discontinuation of SSRIs due to adverse events; Mini-Mental State Examination score <24; worsening angina or congestive heart failure symptoms in previous week; …

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