Impact of early administration of sertraline on cognitive and behavioral recovery in the first year after moderate to severe traumatic brain injury.
OBJECTIVE
To assess the efficacy of sertraline administered in the first 3 months after moderate to severe traumatic brain injury (TBI) in improving cognitive and behavioral outcomes.


METHODS
Double-blind, randomized controlled trial.


METHODS
Academic medical center.


METHODS
Ninety-nine individuals randomized to placebo (n = 50) or sertraline 50 mg (n = 49) conditions. There were no group differences in age, gender, education, or severity of injury.


METHODS
Participants were enrolled an average of 21 days after injury (none > 8 weeks), followed by oral administration of placebo or sertraline 50 mg for 3 months.


METHODS
Wechsler Memory Scale-Third Edition Logical Memory, Trail Making Test, Wechsler Adult Intelligence Scale-Third Edition Working Memory Index, Symbol-Digit Modalities Test, Wisconsin Card Sorting Test (64-item), Neurobehavioral Functioning Inventory administered 3, 6, and 12 months after the onset of injury.


RESULTS
Early administration of sertraline did not result in improved cognitive functioning during the year after injury compared with placebo administration. Those receiving placebo performed marginally better than the treatment group on a measure of executive function, but this appeared to be inauthentic. The treatment group followed expected recovery patterns based on existing literature. The placebo group performed better than expected on some measures, primarily due to differential dropout.


CONCLUSIONS
Sertraline does not appear to prevent development of cognitive and behavioral problems following TBI, although this does not negate evidence for the treatment (as opposed to prophylactic) role of sertraline to address emotional and neurobehavioral problems in individuals with TBI.
Baños
James H
JH
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL 35249, USA. banos@uab.edu
Novack
Thomas A
TA
Brunner
Robert
R
Renfroe
Sharon
S
Lin
Hui-Yi
HY
Meythaler
Jay
J
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000188:drug therapy* / Q000534:rehabilitation; D003072:Cognition Disorders / Q000517:prevention & control*; D004311:Double-Blind Method; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control*; D008875:Middle Aged; D009483:Neuropsychological Tests; D020127:Recovery of Function; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D020280:Sertraline / Q000627:therapeutic use*; D014888:Wechsler Scales; D055815:Young Adult
D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline