Can sertraline help to prevent depression during the first year after TBI?

Early Studies

Early Studies: About 30-50% of people become depressed in the first year after a moderate-severe TBI. This can affect recovery. The depression can be caused by the changes in lifestyle that occur with TBI (such as not driving, not working, and not having a normal social life), but there is a possibility that the depression can also be caused by disruption of brain chemicals (neurotransmitters) that occurs because of the brain injury. If it is disruption of brain chemicals that leads to depression, then it might be possible to change the levels of those brain chemicals and lessen the chances of developing depression.

This Study

This study included 99 people assigned at random to a placebo or active drug group. The active drug was sertraline (Zoloft), which was taken for 3 months, starting just a few week after TBI. No one was depressed when the study started. The people were followed by phone and also made three visits to a doctor’s office. There was no significant difference in the number of people in each group who developed depression during the first year after the injury. So, it did not appear that the medication, at the dosage used, was effective in preventing depression. This lends weight to the idea that the disruption of life after an injury is having more effect on depression than a disruption of brain chemicals.

Who May Be Affected By These Findings

People with traumatic brain injury, caregivers and those providing health care to people with TBI.

Caveats

This study does not address the effectiveness of medications to treat depression when it occurs. Such medications are effective. The study only says that taking these medications before depression will not prevent depression from occurring.

Bottom Line

There is no basis for giving sertraline early in recovery and thinking that it will stop depression from occurring.

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