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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?


Embedded ImageDesign:

Randomised controlled 2×2 factorial trial.

Embedded ImageAllocation:


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 …

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  • For correspondence: François Lespérance, MD, Centre Hospitalier de l’Université de Montréal, 1560 Sherbrooke E, Montreal, Quebec, Canada H2L 4M1; francois.lesperance{at}

  • Competing interests: None.

  • Sources of funding: Canadian Institutes of Health Research (CIHR) Clinical Trials Programme, Fondation du Centre Hospitalier de l’Université de Montréal, and the Fondation de l’Institut de Cardiologie de Montréal.