Problems With Ensuring a Double Blind

Letter to the Editor

Sir: We read with interest the article by Zanardi et al evaluating the effectiveness of venlafaxine versus fluvoxamine in the treatment of delusional depression. Delusional depression, as the authors point out, is a difficult condition to treat with the limited treatment options available to clinicians. New treatment trials such as that reported in this study are always welcome. We have, however, 2 concerns about the design used by the authors that may have compromised the integrity of the blind in their study.