Depression can often follow a traumatic brain injury, but new research suggests the antidepressant Zoloft might help prevent this from happening.
Low dose of sertraline
One expert said prior studies have produced similar findings.
The new research "provides further support of the possibility that depression following neurological injury could be avoided, rather than treated after the fact," said Dr Paul Mattis. He is chief of neuropsychology at Northwell Health's Neuroscience Institute in Manhasset, New York.
The new study was led by Dr Ricardo Jorge, of Baylor College of Medicine in Houston. His team randomly assigned 94 patients who suffered a traumatic brain injury to receive a low dose of sertraline (Zoloft) or a placebo pill for six months, or until they developed symptoms of a mood disorder.
Overall, 46 people took the placebo, while the other 48 were given the 100 milligrams of sertraline each day.
The study suggests that giving patients a low dose of sertraline following a brain injury could help prevent the onset of depression.
However, the study population was small and Jorge's team stressed that larger studies must be done to confirm these findings before new treatment recommendations can be made.
Incidents of side effects
Dr Aaron Pinkhasov is chair of behavioural health at Winthrop-University Hospital in Mineola, New York. He agreed that the new findings aren't sufficient to change current practice.
"This study does not convince me to start low-dose antidepressants before I see any signs of depression," he said.
Drug side effects are a concern, as well, Pinkasov said. "We should always consider the risks/benefits ratio of medications, and while selective serotonin reuptake inhibitors [SSRI antidepressants] generally have a benign side effects profile, some of the side effects are still there," he said.
Indeed, there were more incidents of side effects such as dry mouth and diarrhea in patients taking sertraline than those on placebo, the researchers noted.
"Instead of starting all patients with TBI (traumatic brain injury) on antidepressants, I would encourage timely and proactive screening for depression, which would likely provide equally useful results," Pinkasov said.
Burden of depression
But Mattis believes that giving TBI patients an antidepressant as a preventive measure might still have merit – if larger trials support this approach.
"The idea that the added burden of depression in patients recovering from brain injury could be reduced is encouraging," he said.
The study was published online in the journal JAMA Psychiatry.