RATIONALE: Postpartum depression (PMD) occurs in roughly 10 % of postpartum women and negatively impacts the mother and her offspring, but there are few placebo-controlled studies of antidepressant treatment in this population. OBJECTIVE: The objective was this study is to compare the selective serotonin reuptake inhibitor (SSRI) sertraline to placebo for treating PMD. METHODS: This was a single-center, 6-week, randomized double-blind placebo-controlled trial of sertraline with a 1-week placebo lead-in. The participants (n = 38) were women with depression onset within 3 months of delivery; a subset (n = 27) met strict DSM-IV criteria for PMD (onset within 4 weeks of delivery). The participants were prescribed sertraline 50 mg or placebo daily to a maximum of 200 mg/day. Primary outcome variables were the Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impressions (CGI) scores, which were used to determine the rates of response and remission. RESULTS:Sertraline produced a significantly greater response rate (59 %) than placebo (26 %) and a more than twofold increased remission rate (53 % vs. 21 %). Mixed models did not reveal significant group by time effects, although in the subset of women who met the DSM-IV criteria, there was a statistically significant group by time effect for the HAM-D, Hamilton Anxiety Rating Scale (HAM-A), and CGI. CONCLUSIONS:Women with PMD are more likely to have a remission of their depression with sertraline treatment, a finding that is more pronounced in women who have onset of depression within 4 weeks of childbirth. These data support the continued use of 4 weeks for the DSM-5 postpartum onset specifier for major depressive disorder.
RCT Entities:
RATIONALE: Postpartum depression (PMD) occurs in roughly 10 % of postpartum women and negatively impacts the mother and her offspring, but there are few placebo-controlled studies of antidepressant treatment in this population. OBJECTIVE: The objective was this study is to compare the selective serotonin reuptake inhibitor (SSRI) sertraline to placebo for treating PMD. METHODS: This was a single-center, 6-week, randomized double-blind placebo-controlled trial of sertraline with a 1-week placebo lead-in. The participants (n = 38) were women with depression onset within 3 months of delivery; a subset (n = 27) met strict DSM-IV criteria for PMD (onset within 4 weeks of delivery). The participants were prescribed sertraline 50 mg or placebo daily to a maximum of 200 mg/day. Primary outcome variables were the Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impressions (CGI) scores, which were used to determine the rates of response and remission. RESULTS:Sertraline produced a significantly greater response rate (59 %) than placebo (26 %) and a more than twofold increased remission rate (53 % vs. 21 %). Mixed models did not reveal significant group by time effects, although in the subset of women who met the DSM-IV criteria, there was a statistically significant group by time effect for the HAM-D, Hamilton Anxiety Rating Scale (HAM-A), and CGI. CONCLUSIONS:Women with PMD are more likely to have a remission of their depression with sertraline treatment, a finding that is more pronounced in women who have onset of depressionwithin 4 weeks of childbirth. These data support the continued use of 4 weeks for the DSM-5 postpartum onset specifier for major depressive disorder.
Authors: N Epperson; K A Czarkowski; D Ward-O'Brien; E Weiss; R Gueorguieva; P Jatlow; G M Anderson Journal: Am J Psychiatry Date: 2001-10 Impact factor: 18.112
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Authors: Karen T Putnam; Marsha Wilcox; Emma Robertson-Blackmore; Katherine Sharkey; Veerle Bergink; Trine Munk-Olsen; Kristina M Deligiannidis; Jennifer Payne; Margaret Altemus; Jeffrey Newport; Gisele Apter; Emmanuel Devouche; Alexander Viktorin; Patrik Magnusson; Brenda Penninx; Anne Buist; Justin Bilszta; Michael O'Hara; Scott Stuart; Rebecca Brock; Sabine Roza; Henning Tiemeier; Constance Guille; C Neill Epperson; Deborah Kim; Peter Schmidt; Pedro Martinez; Arianna Di Florio; Katherine L Wisner; Zachary Stowe; Ian Jones; Patrick F Sullivan; David Rubinow; Kevin Wildenhaus; Samantha Meltzer-Brody Journal: Lancet Psychiatry Date: 2017-05-03 Impact factor: 27.083
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Authors: Jennifer Valeska Elli Brown; Claire A Wilson; Karyn Ayre; Lindsay Robertson; Emily South; Emma Molyneaux; Kylee Trevillion; Louise M Howard; Hind Khalifeh Journal: Cochrane Database Syst Rev Date: 2021-02-13