Pharmacotherapy for Depression Posttraumatic Brain Injury: A Meta-analysis. Issue 4 (July 2016)

• Record Type: Journal Article
• Authors: Salter, Katherine L.; McClure, J. Andrew; Foley, Norine C.; Sequeira, Keith; Teasell, Robert W.
• Is Part Of: Journal of head trauma rehabilitation. Volume 31:Issue 4(2016:Jul./Aug.)
• Publication Date: 2016-07
• Subjects: depression -- meta-analysis -- pharmacotherapy -- traumatic brain injury; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000193
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : 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.