Dr. Xiong et al. state that while we suggested that depression in the setting of beta-blockade use is seen more frequently in women, Crane et al. (1) examined 84 women and found no difference in depression symptoms between women who did and did not use beta-blockers. Although that study suggested that the use of beta-blockade does not cause depression in women, the study had several limitations, including its cross-sectional design, making it difficult to identify causation (even though this is more of an issue when an association is found). We also wish to make the point that very large doses of beta-blockade were used in our case study relative to the doses administered to women in the Crane et al. study, who were post-myocardial infarction and received only conventional doses, thus limiting comparability.