The randomization code was not broken until all data had been analysed and conclusions drawn, as suggested previously [Gotzsche, 1996]. At the assessment after 4 weeks of intervention, every participant and the principal investigator (UK) made a guess as to which intervention the participant

had received. A large proportion of the participants said, ‘I do not know’ but were asked to give their best guess. The agreement between the actual intervention and the guesses was estimated Inhibitors,research,lifescience,medical to assess the degree to which blinding had been demasked, thus κ<0, no; κ=0.0–0.20, slight; κ=0.21–0.40, some; κ=0.41–0.60, moderate; κ=0.61–0.80, substantial; κ=0.81–1.00, almost complete demasking. Interventions The participants were randomized to self-administer a single dose of either escitalopram 10mg or matching placebo each evening for 4 weeks. The rationale for evening Inhibitors,research,lifescience,medical administration

of the intervention was to minimize possible discomfort by nausea. Escitalopram and placebo tablets were identical in appearance, colour, smell, and solubility allowing for blinding of the assignment to intervention or placebo. H. Lundbeck A/S provided identically appearing blister packages containing escitalopram or placebo. An independent pharmacist Inhibitors,research,lifescience,medical then packed, sealed, and numbered the drug packages according to a randomization list provided and concealed by the CTU. Adherence to the protocol was sought by making weekly telephone calls to the enrolled participants. The participants were asked at the end of the trial how adherent they had been to the protocol, and if they had missed taking any Inhibitors,research,lifescience,medical tablets. On completion of 4 weeks of intervention participants entered a 5-day blinded down-titration period to nil medication. MM102 neuropsychological tests Cognitive functions were measured with neuropsychological tests at baseline and following

4 weeks of intervention. Descriptions Inhibitors,research,lifescience,medical of most of these tests may be found in ‘A compendium of neuropsychological tests’ [Strauss et al. 2006] and modifications are noted below. The 45-word Danish version of National Adult Reading Test (DART-45) [Nelson and O'Connell, 1978] was used as a measure of intelligence. Thirteen measures from the other tests were subjected to factor analysis, yielding the following four factors. Factor 1. Visuomotor/visuospatial function This factor included five measures: Trail Making A & B, connecting numbers (A) and alternating numbers Isotretinoin and letters (B); Symbol Digit Modalities Test (SDMT), a sensitive test requiring the subject to write numbers corresponding to each of nine symbols indicated in a coding key, in 90 seconds; Block Design [Gade et al. 1988] a variant of the WAIS subtest with a score made up of the mean time in seconds to complete each of 12 designs with four blocks with red, white, and half red/white sides; Rey–Osterrieth Complex Figure, 3-minute free recall (copy score not included). Factor 2.