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To the Editor: Dr Robinson and colleagues¹ reported that poststroke patients randomized to either escitalopram or problem-solving therapy had a lower annual incidence of depression compared with those prescribed placebo. Although the authors discussed the finding that both treatments outperformed placebo, they did not make a direct statistical comparison between the active treatments. It would be valuable to know how psychosocial treatment compared with prescription medication.

The reported incidence data showed that the rate of depression was approximately the same in both escitalopram (8.5%) and problem-solving therapy (11.9%) groups. This difference does not appear to be either clinically or statistically significant. The authors could enhance the value of their research by providing this additional piece of analysis.

Financial Disclosures: None reported.

Jeffrey Lacasse, PhD
jeffreylacasse@mac.com
College of Human Services
Arizona State University
Phoenix

Jonathan Leo, PhD
Department of Neuroanatomy
DeBusk College of Osteopathic Medicine
Lincoln Memorial University
Harrogate, Tennessee

1. Robinson RG, Jorge RE, Moser DJ; et al. Escitalopram and problem-solving therapy for prevention of poststroke depression: a randomized controlled trial. JAMA. 2008;299(20):2391-2400. FREE FULL TEXT

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2008;300(15):1757-1758.

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