A Randomized Controlled Trial of Antidepressant Continuation for Major Depression Following Traumatic Brain Injury
J Clin Psychiatry 2010;71(9):1125-1130
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Objective: This study examines whether continuation therapy with citalopram can prevent a relapse following remission of major depression due to traumatic brain injury.
Method: After 65 subjects with DSM-IV–diagnosed major depression following traumatic brain injury were treated with open-label citalopram (20 mg to 50 mg/d), 25 subjects (38.5%) met criteria for remission. Of those, 21 (84.0%) were randomly assigned to either same-dose citalopram or placebo and followed monthly over 40 weeks. Remission was defined as a Hamilton Depression Rating Scale (HDRS) score of ≤ 7 or a Clinical Global Impressions-Improvement rating of “much improved” or better. The main outcome variable was the presence of relapse, as defined by meeting criteria for major depressive episode according to the DSM-IV and an HDRS score ≥ 16. Data were collected from February 16, 2005, to May 5, 2008.
Results: Ten subjects were randomly assigned to citalopram and 11 to placebo. There were 3 dropouts, including 1 for adverse drug effects (diarrhea). Relapse occurred in 11 subjects (52.4%), with a mean ± SD time to relapse of 23.52 ± 16.6 weeks. The groups did not differ in relapse rates (drug: 50.0% [5/10] vs placebo: 54.5% [6/11], Fisher exact test, P = .835) or time to relapse (log rank test χ2 = 0.148, P = .700).
Conclusions: The present study suggests important limitations of continuation pharmacotherapy in the prevention of relapse of major depression following traumatic brain injury.
Trial Registration: clinicaltrials.gov Identifier: NCT00162916
J Clin Psychiatry
Submitted: December 15, 2008; accepted April 21, 2009.
Online ahead of print: April 20, 2010 (doi:10.4088/JCP.09m05086blu).
Corresponding author: Mark J. Rapoport, MD, FRCPC, 2075 Bayview Ave, Rm FG37, Toronto, Ontario, M4N 3M5, Canada (email@example.com).