Can sertraline prevent depressive disorders following traumatic brain injury?

Ricardo E. Jorge, M.D., of the Baylor College of Medicine, Houston, and coauthors tackled that question in a new article published online by JAMA Psychiatry. The authors conducted a randomized clinical trial at a university hospital over four years with 24 weeks of follow-up. A total of 94 patients consented and were assigned to receive placebo (n=46) or sertraline (n=48) at a dose of 100 mg/day for 24 weeks or until a mood disorder developed.

Results suggest sertraline at a low dose early after TBI appears to be an efficacious strategy to prevent depression after TBI but more study is needed before considering possible changes to treatment guidelines.

Limitations to the current study include its small sample size.

"Given the prevalence and functional effect of depression among patients with TBI, these findings have profound therapeutic implications. However, although our findings are novel and provocative, recommending a change in the guidelines to treat patients with TBI requires replication of these findings in multicenter studies. In addition, it would be important to study whether combining antidepressants with behavioral interventions, such as psychotherapy or cognitive rehabilitation protocols, will optimize long-term functional outcomes," the authors conclude.