Effects of Citalopram and Interpersonal Psychotherapy on Depression in Patients With Coronary Artery Disease

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Abstract
Since the early 1990s, studies have reported prevalences of major depression between 17% and 27% in hospitalized patients with coronary artery disease (CAD).1 Most have also demonstrated that depression has a negative cardiac prognostic impact.2,3 Only 1 large randomized trial, the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study,4 has tried to determine whether treating depression could improve cardiac prognosis in CAD patients. Although ENRICHD demonstrated that a combination of short-term individual cognitive behavior therapy (CBT) and a selective serotonin reuptake inhibitor (SSRI), when needed, was significantly better than usual care at reducing depressive symptoms over 6 months in depressed or socially isolated myocardial infarction patients, the effect size was small. The study failed to show that the ENRICHD treatment protocol was better than usual care in preventing all-cause mortality and recurrent myocardial infarctions.