SSRIs and Medical Illness: The Good and the Bad

As the U.S. population ages, depressive illness and its treatments are increasingly complicated by comorbid medical illnesses and the medical risks of treatment. Two Canadian studies provide new insights.

In a 12-week, randomized, controlled study, researchers examined the efficacy of citalopram (20–40 mg/day), manual-based interpersonal psychotherapy, or both in 284 patients with depression (Hamilton Rating Scale for Depression score, ≥20) and with established, non-acute coronary artery disease. Citalopram produced significantly greater response (53% vs. 40%) and remission (36% vs. 22%) than did pill placebo. Interpersonal psychotherapy, either alone or combined with citalopram, was not better than clinical management. Effects of citalopram…