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Abstract:

IMPORTANCE Prevention is more effective than treatment to decrease the burden of significant medical conditions such as depressive disorders, a major cause of disability worldwide. Traumatic brain injury (TBI) is a candidate for selective strategies to prevent depression given the incidence, prevalence, and functional effect of depression that occurs after TBI. OBJECTIVE To assess the efficacy of sertraline treatment in preventing depressive disorders following TBI. DESIGN, SETTING, AND PARTICIPANTS A double-blind, placebo-controlled, parallel-group randomized clinical trial was conducted at a university hospital from July 3, 2008, to September 17, 2012, with 24 weeks of follow-up. A consecutive sample of 534 patients aged 18 to 85 years, hospitalized for mild, moderate, or severe TBI, was eligible for the study. Ninety-four patients consented to participate and were randomized (46 to placebo and 48 to sertraline), of whom 79 (84%) completed the study. Intention-To-Treat data analysis was conducted from July 1, 2014, to December 31, 2015. INTERVENTIONS Placebo or sertraline, 100mg/d, for 24 weeks or until development of a mood disorder. MAIN OUTCOMES AND MEASURES Time to onset of depressive disorders, as defined by the DSM-IV, associated with TBI. RESULTS Of the 94 patients in the study (38 female and 56 male; 92 white), the number needed to treat to prevent depression after TBI at 24 weeks was 5.9 (95%CI, 3.1-71.1; x2 = 4.6; P = .03) for sertraline treatment vs placebo. The influence of sertraline in the course of neuropsychological variables was not detected. The intervention was well tolerated, and adverse effects were mild in both the sertraline and placebo groups. CONCLUSIONS AND RELEVANCE Sertraline appears to be efficacious to prevent the onset of depressive disorders following TBI. Future studies should replicate these findings in a large sample of patients with TBI and depict their long-Term physical, cognitive, behavioral, and functional outcomes. Copyright 2016 American Medical Association. All rights reserved.

Registro:

Documento: Artículo
Título:Sertraline for preventing mood disorders following traumatic brain injury a randomized clinical trial
Autor:Jorge, R.E.; Acion, L.; Burin, D.I.; Robinson, R.G.
Filiación:Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, United States
Iowa Consortium for Substance Abuse Research and Evaluation, University of Iowa, Iowa City, United States
Instituto de Cálculo, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
Facultad de Psicología, Universidad de Buenos Aires-Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
Department of Psychiatry, University of Iowa, Iowa City, United States
Palabras clave:placebo; sertraline; sertraline; adult; aged; Article; controlled study; depression; diarrhea; dizziness; double blind procedure; fatigue; female; follow up; human; injury severity; insomnia; major clinical study; male; mood disorder; nausea; neuropsychological test; physiotherapy; randomized controlled trial; side effect; sweating; traumatic brain injury; xerostomia; complication; cross-sectional study; Denmark; Depressive Disorder; intention to treat analysis; middle aged; mortality; psychology; register; traumatic brain injury; treatment outcome; university hospital; young adult; Adult; Aged; Brain Injuries, Traumatic; Cross-Sectional Studies; Denmark; Depressive Disorder; Double-Blind Method; Female; Follow-Up Studies; Hospitals, University; Humans; Intention to Treat Analysis; Male; Middle Aged; Registries; Sertraline; Treatment Outcome; Young Adult
Año:2016
Volumen:73
Número:10
Página de inicio:1041
Página de fin:1047
DOI: http://dx.doi.org/10.1001/jamapsychiatry.2016.2189
Título revista:JAMA Psychiatry
Título revista abreviado:JAMA Psychiatry
ISSN:2168622X
CAS:sertraline, 79617-96-2; Sertraline
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_2168622X_v73_n10_p1041_Jorge

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Citas:

---------- APA ----------
Jorge, R.E., Acion, L., Burin, D.I. & Robinson, R.G. (2016) . Sertraline for preventing mood disorders following traumatic brain injury a randomized clinical trial. JAMA Psychiatry, 73(10), 1041-1047.
http://dx.doi.org/10.1001/jamapsychiatry.2016.2189
---------- CHICAGO ----------
Jorge, R.E., Acion, L., Burin, D.I., Robinson, R.G. "Sertraline for preventing mood disorders following traumatic brain injury a randomized clinical trial" . JAMA Psychiatry 73, no. 10 (2016) : 1041-1047.
http://dx.doi.org/10.1001/jamapsychiatry.2016.2189
---------- MLA ----------
Jorge, R.E., Acion, L., Burin, D.I., Robinson, R.G. "Sertraline for preventing mood disorders following traumatic brain injury a randomized clinical trial" . JAMA Psychiatry, vol. 73, no. 10, 2016, pp. 1041-1047.
http://dx.doi.org/10.1001/jamapsychiatry.2016.2189
---------- VANCOUVER ----------
Jorge, R.E., Acion, L., Burin, D.I., Robinson, R.G. Sertraline for preventing mood disorders following traumatic brain injury a randomized clinical trial. JAMA Psychiatry. 2016;73(10):1041-1047.
http://dx.doi.org/10.1001/jamapsychiatry.2016.2189