Research Reports - Sertraline for major depression during the year following traumatic brain injury

J Head Trauma Rehabil. 2017 May 17. doi: 10.1097/HTR.0000000000000322. [Epub
ahead of print]

Fann JR(1), Bombardier CH, Temkin N, Esselman P, Warms C, Barber J, Dikmen S.

OBJECTIVE: Major depressive disorder (MDD) is common and associated with impaired
functioning after traumatic brain injury (TBI). Few placebo-controlled
antidepressant trials exist in this population. We evaluated the efficacy and
tolerability of sertraline for MDD within 1 year of sustaining a TBI.
SETTING: Level I trauma center.
PARTICIPANTS: Adults with MDD within 1 year of hospitalization for complicated
mild to severe TBI.
DESIGN: Randomized, double-blind, placebo-controlled trial.
MAIN MEASURES: Twelve-week treatment response on the 17-item Hamilton Depression
Rating Scale. We also assessed symptom improvement and remission.
RESULTS: We randomized 62 participants: 32% sustained a severe TBI, 68% had
significant anxiety, 63% had a history of prior MDD, and 69% had a history of
alcohol or drug dependence. Depression significantly improved from baseline to 12
weeks in both treatment groups (P < .001). There were no significant differences
between the sertraline and placebo groups over 12 weeks on depression severity,
response, or remission. The sertraline group had significant improvement on speed
of information processing compared with the placebo group (P < .006).
CONCLUSION: Sertraline monotherapy was not superior to placebo for MDD in people
with post-acute complicated mild to severe TBI. Research is needed on the
effectiveness of interventions that also address the significant psychosocial
needs of this population.

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