A randomized,placebo-controlled,double-blind trial of sertraline for postpartum depression |
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Authors: | Liisa Hantsoo Deborah Ward-O’Brien Kathryn A. Czarkowski Ralitza Gueorguieva Lawrence H. Price C. Neill Epperson |
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Affiliation: | 1. Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA 2. Penn Center for Women’s Behavioral Wellness, 3535 Market St., Philadelphia, PA, 19104, USA 3. Penn Center for the Study of Sex and Gender in Behavioral Health, 3535 Market St., Philadelphia, PA, 19104, USA 4. Department of Psychiatry, School of Medicine, Yale University, 300 George St., New Haven, CT, 06511, USA 5. Department of Biostatistics, School of Public Health, Yale University, 60 College St., New Haven, CT, 06520, USA 6. School of Medicine, Yale University, 60 College St., New Haven, CT, 06520, USA 7. Butler Hospital, Alpert Medical School, Brown University, 345 Blackstone Blvd, Providence, RI, 02906, USA 8. Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, 345 Blackstone Blvd, Providence, RI, 02906, USA 9. Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce St., Philadelphia, PA, 19104, USA
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Abstract: | Rationale Postpartum depression (PMD) occurs in roughly 10 % of postpartum women and negatively impacts the mother and her offspring, but there are few placebo-controlled studies of antidepressant treatment in this population. Objective The objective was this study is to compare the selective serotonin reuptake inhibitor (SSRI) sertraline to placebo for treating PMD. Methods This was a single-center, 6-week, randomized double-blind placebo-controlled trial of sertraline with a 1-week placebo lead-in. The participants (n?=?38) were women with depression onset within 3 months of delivery; a subset (n?=?27) met strict DSM-IV criteria for PMD (onset within 4 weeks of delivery). The participants were prescribed sertraline 50 mg or placebo daily to a maximum of 200 mg/day. Primary outcome variables were the Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impressions (CGI) scores, which were used to determine the rates of response and remission. Results Sertraline produced a significantly greater response rate (59 %) than placebo (26 %) and a more than twofold increased remission rate (53 % vs. 21 %). Mixed models did not reveal significant group by time effects, although in the subset of women who met the DSM-IV criteria, there was a statistically significant group by time effect for the HAM-D, Hamilton Anxiety Rating Scale (HAM-A), and CGI. Conclusions Women with PMD are more likely to have a remission of their depression with sertraline treatment, a finding that is more pronounced in women who have onset of depression within 4 weeks of childbirth. These data support the continued use of 4 weeks for the DSM-5 postpartum onset specifier for major depressive disorder. |
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