TY - JOUR
T1 - The Effect of Antidepressants on Depression After Traumatic Brain Injury
T2 - A Meta-analysis
AU - Kreitzer, Natalie
AU - Ancona, Rachel
AU - Mccullumsmith, Cheryl
AU - Kurowski, Brad G.
AU - Foreman, Brandon
AU - Ngwenya, Laura B.
AU - Adeoye, Opeolu
N1 - Funding Information:
Dr Foreman receives speaking fees from UCB Pharma Inc and research funding through the Department of Defense and the National Institutes of Health/National Institutes of Neurological Disorders and Stroke.
Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Objective: Following traumatic brain injury (TBI), depressive symptoms are common and may influence recovery. We performed a meta-analysis to estimate the benefit of antidepressants following TBI and compare the estimated effects between antidepressants and placebo. Participants: Multiple databases were searched to find prospective pharmacological treatment studies of major depressive disorder (MDD) in adults following TBI. Main Measures: Effect sizes for antidepressant medications in patients with TBI were calculated for within-subjects designs that examined change from baseline after receiving medical treatment and treatment/placebo designs that examined the differences between the antidepressants and placebo groups. Design: A random-effects model was used for both analyses. Results: Of 1028 titles screened, 11 were included. Pooled estimates showed nonsignificant difference in reduction of depression scores between medications and placebo (standardized mean difference of 5 trials = -0.3; 95% CI, -0.6 to 0.0; I2 = 17%), and a significant reduction in depression scores for individuals after pharmacotherapy (mean change = -11.2; 95% CI, -14.7 to -7.6 on the Hamilton Depression Scale; I2 = 87%). Conclusions: This meta-analysis found no significant benefit of antidepressant over placebo in the treatment of MDD following TBI. Pooled estimates showed a high degree of bias and heterogeneity. Prospective studies on the impact of antidepressants in well-defined cohorts of TBI patients are warranted.
AB - Objective: Following traumatic brain injury (TBI), depressive symptoms are common and may influence recovery. We performed a meta-analysis to estimate the benefit of antidepressants following TBI and compare the estimated effects between antidepressants and placebo. Participants: Multiple databases were searched to find prospective pharmacological treatment studies of major depressive disorder (MDD) in adults following TBI. Main Measures: Effect sizes for antidepressant medications in patients with TBI were calculated for within-subjects designs that examined change from baseline after receiving medical treatment and treatment/placebo designs that examined the differences between the antidepressants and placebo groups. Design: A random-effects model was used for both analyses. Results: Of 1028 titles screened, 11 were included. Pooled estimates showed nonsignificant difference in reduction of depression scores between medications and placebo (standardized mean difference of 5 trials = -0.3; 95% CI, -0.6 to 0.0; I2 = 17%), and a significant reduction in depression scores for individuals after pharmacotherapy (mean change = -11.2; 95% CI, -14.7 to -7.6 on the Hamilton Depression Scale; I2 = 87%). Conclusions: This meta-analysis found no significant benefit of antidepressant over placebo in the treatment of MDD following TBI. Pooled estimates showed a high degree of bias and heterogeneity. Prospective studies on the impact of antidepressants in well-defined cohorts of TBI patients are warranted.
KW - antidepressant
KW - depression
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85065657775&partnerID=8YFLogxK
U2 - 10.1097/HTR.0000000000000439
DO - 10.1097/HTR.0000000000000439
M3 - Article
C2 - 30169440
AN - SCOPUS:85065657775
VL - 34
SP - E47-E54
JO - Journal of Head Trauma Rehabilitation
JF - Journal of Head Trauma Rehabilitation
SN - 0885-9701
IS - 3
ER -