Literature DB >> 19406291

A randomized controlled trial of sertraline for the treatment of depression in persons with traumatic brain injury.

Teresa A Ashman1, Joshua B Cantor, Wayne A Gordon, Lisa Spielman, Steve Flanagan, Annika Ginsberg, Clara Engmann, Matthew Egan, Felicia Ambrose, Brian Greenwald.   

Abstract

OBJECTIVE: To examine the efficacy of sertraline in the treatment of depression after traumatic brain injury (TBI).
DESIGN: Double-blind, randomized controlled trial.
SETTING: Research center at a major urban medical center. PARTICIPANTS: Subjects were a referred and volunteer sample of 52 participants with TBI, a diagnosis of major depression disorder (MDD), and a score on the Hamilton Rating Scale for Depression (HAM-D) of 18 or greater. The majority of the sample was male (58%), had less than 14 years of education (73%), had incomes below $20,000 (82%), and were from minority backgrounds (75%). Approximately one third of the sample had mild brain injuries, and two thirds had moderate to severe brain injuries. The mean age was 47+/-11, and the mean time since injury was 17+/-14 years. One participant withdrew from the study because of side effects. INTERVENTION: Daily oral sertraline in doses starting at 25mg and increasing to therapeutic levels (up to 200mg) or placebo for 10 weeks. MAIN OUTCOME MEASURES: The HAM-D, the Beck Anxiety Inventory, and the Life-3 quality of life (QOL).
RESULTS: No statistically significant differences were found at baseline between drug and placebo groups on baseline measures of depression (24.8+/-7.3 vs 27.7+/-7.0), anxiety (16.4+/-12.3 vs 24.0+/-14.9), or QOL (2.96+/-1.0 vs 2.9+/-0.9). The income level of those receiving placebo was significantly lower than those participants receiving medication. Analyses of covariance revealed significant changes from preintervention to posttreatment for all 3 outcome measures (P<.001) but no group effects. Random-effects modeling did not find any significant difference in patterns of scores of the outcome measures between the placebo and medication groups.
CONCLUSIONS: Both groups showed improvements in mood, anxiety, and QOL, with 59% of the experimental group and 32% of the placebo group responding to the treatment, defined as a reduction of a person's HAM-D score by 50%.

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Year:  2009        PMID: 19406291     DOI: 10.1016/j.apmr.2008.11.005

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


  28 in total

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2.  Is Electroconvulsive Therapy a Treatment for Depression Following Traumatic Brain Injury?

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Review 3.  Neurotransmitter changes after traumatic brain injury: an update for new treatment strategies.

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4.  Depression following traumatic brain injury in mice is associated with down-regulation of hippocampal astrocyte glutamate transporters by thrombin.

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5.  Rates of major depressive disorder and clinical outcomes following traumatic brain injury.

Authors:  Charles H Bombardier; Jesse R Fann; Nancy R Temkin; Peter C Esselman; Jason Barber; Sureyya S Dikmen
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Review 6.  Depression following traumatic brain injury: epidemiology, risk factors and management.

Authors:  Mark J Rapoport
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7.  Sertraline for Major Depression During the Year Following Traumatic Brain Injury: A Randomized Controlled Trial.

Authors:  Jesse R Fann; Charles H Bombardier; Nancy Temkin; Peter Esselman; Catherine Warms; Jason Barber; Sureyya Dikmen
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8.  Immune activation promotes depression 1 month after diffuse brain injury: a role for primed microglia.

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9.  Depression Trajectories during the First Year after Traumatic Brain Injury.

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Review 10.  Treatment for depression after traumatic brain injury: a systematic review.

Authors:  Jesse R Fann; Tessa Hart; Katherine G Schomer
Journal:  J Neurotrauma       Date:  2009-12       Impact factor: 5.269

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