Research Reports - Pharmacotherapy for depression after brain injury

J Head Trauma Rehabil. 2015 Oct 16. [Epub ahead of print]

Salter KL(1), McClure JA, Foley NC, Sequeira K, Teasell RW.

OBJECTIVE: To examine the effectiveness of pharmacotherapy for the treatment of
depression following traumatic brain injury (TBI).
DESIGN: Systematic review and meta-analysis. Multiple electronic databases were
searched to identify relevant studies examining effectiveness of pharmacotherapy
for depression post-TBI. Clinical trials evaluating the use of pharmacotherapy in
individuals with depression at baseline and using standardized assessments of
depression were included. Data abstracted included sample size, antidepressant
used, treatment timing/duration, method of assessment, and results pertaining to
impact of treatment. Study quality was assessed using a modified Jadad scale.
RESULTS: Nine studies met criteria for inclusion. Pooled analyses based on
reported means (standard deviations) from repeated assessments of depression
showed that, over time, antidepressant treatment was associated with a
significant effect in favor of treatment (Hedges g = 1.169; 95% confidence
interval, 0.849-1.489; P < .001). Similarly, when limited to placebo-controlled
trials, treatment was associated with a significant reduction in symptoms
(standardized mean difference = 0.84; 95% confidence interval, 0.314-1.366; P =
.002).
CONCLUSION: Pharmacotherapy after TBI may be associated with a reduction in
depressive symptomatology. Given limitations within the available literature,
further well-powered, placebo-controlled trials should be conducted to confirm
the effectiveness of antidepressant therapy in this population. 

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