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Cited by 82Traumatic Brain Injury ResearchTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Sertraline for major depression during the year following traumatic brain injury: a randomized controlled trial

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Fann, Jesse R., Bombardier, Charles H., Temkin, Nancy, Esselman, Peter, Warms, Catherine, Barber, Jason, Dikmen, Sureyya·2017·Journal of Head Trauma Rehabilitation
DOI 10.1097/htr.0000000000000322PMC PMC5593759
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Abstract

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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  • Standard pharmacological interventions such as SSRIs have failed to show efficacy for depression in the context of TBI in randomized controlled trials.

    “Additionally, the standard pharmacological interventions that are often first-line treatments for depression in the general population (e.g., SSRIs) have failed to show efficacy in the context of TBI in randomized controlled trials (12, 13).”

    From Adaptive trial for the treatment of depressive symptoms associated with concussion using accelerated intermittent theta burst stimulation (ADEPT): rationale, design and methods (2025) · cites this paper as [13]

    The Results (Treatment Efficacy; page unavailable) found no significant difference between sertraline and placebo for depression, and the Discussion says an earlier sertraline trial likewise found no significant treatment difference. These passages support the claim for sertraline in those trials, but not its broader implication that SSRIs or standard pharmacological treatments generally have failed in TBI; the Introduction describes preliminary evidence supporting SSRIs. (LLM, conf=0.85)

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Research works printed but not linked: 39

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Cited by

Sorted by citations

Authors
Fann, J. R., Bombardier, C. H., Temkin, N., Esselman, P., Warms, C., Barber, J., & Dikmen, S.
Affiliations
University of Washington (US)
ORCID
Venue
Journal of Head Trauma Rehabilitation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-09
Volume
32
Issue
5
Pages
332-342
ISSN
0885-9701 (ISSN-L)
DOI
10.1097/htr.0000000000000322
PMC
PMC5593759
OpenAlex
W2616694829
Cited by
82
References
5
Citations by year
2026: 2 · 2025: 8 · 2024: 13 · 2023: 6 · 2022: 10 · 2021: 5 · 2020: 15 · 2019: 15 · 2018: 7 · 2017: 1
FWCI
8.14
Type
journal article
Language
en
Open access
Locations
  • Journal of Head Trauma Rehabilitation (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD039415)
Topics
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
sertraline, major depressive disorder, traumatic brain injury, antidepressant efficacy, placebo comparison, processing speed, depression remission, alcohol and drug addiction
MeSH terms
Brain Injuries, Traumatic, Adult, Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Severity of Illness Index, Time Factors, Multivariate Analysis, Treatment Outcome, Sertraline

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