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To the Editor: In a placebo-controlled, randomized clinical trial, Dr Angermann and colleagues reported that escitalopram did not reduce all-cause death or hospitalization in depressed patients with heart failure.1 It is not clear why the authors expected that it would, as it does not reduce mild to moderate levels of depression.
At baseline, patients had a mean Montgomery-Åsberg Depression Rating Scale (MADRS) score of 20 to 22 indicating mild to moderate severity of depression. After 12 weeks, MADRS scores in the placebo and the escitalopram group were 12.5 and 11.2, respectively.
Ströhle A, Rieckmann N. Escitalopram and Outcomes Among Patients With Depression and Heart Failure. JAMA. 2016;316(14):1494. doi:10.1001/jama.2016.13855