A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression

被引:86
作者
Hantsoo, Liisa [1 ,2 ,3 ]
Ward-O'Brien, Deborah [4 ]
Czarkowski, Kathryn A. [1 ,2 ,3 ]
Gueorguieva, Ralitza [5 ,6 ]
Price, Lawrence H. [7 ,8 ]
Epperson, C. Neill [1 ,2 ,3 ,9 ]
机构
[1] Univ Penn, Perelman Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA
[2] Penn Ctr Womens Behav Wellness, Philadelphia, PA 19104 USA
[3] Penn Ctr Study Sex & Gender Behav Hlth, Philadelphia, PA 19104 USA
[4] Yale Univ, Sch Med, Dept Psychiat, New Haven, CT 06511 USA
[5] Yale Univ, Sch Publ Hlth, Dept Biostat, New Haven, CT 06520 USA
[6] Yale Univ, Sch Med, New Haven, CT 06520 USA
[7] Brown Univ, Alpert Med Sch, Butler Hosp, Providence, RI 02906 USA
[8] Brown Univ, Alpert Med Sch, Dept Psychiat & Human Behav, Providence, RI 02906 USA
[9] Univ Penn, Dept Obstet & Gynecol, Perelman Sch Med, Philadelphia, PA 19104 USA
关键词
Postpartum; Puerperal; Depression; Sertraline; SSRI; Pregnancy; Women; SEROTONIN REUPTAKE INHIBITORS; POSTNATAL DEPRESSION; ANXIETY; WOMEN; MOTHERS; PHARMACOKINETICS; ALLOPREGNANOLONE; METAANALYSIS; FLUOXETINE; DISORDERS;
D O I
10.1007/s00213-013-3316-1
中图分类号
Q189 [神经科学];
学科分类号
071006 [神经生物学];
摘要
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. The objective was this study is to compare the selective serotonin reuptake inhibitor (SSRI) sertraline to placebo for treating PMD. 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. 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. 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.
引用
收藏
页码:939 / 948
页数:10
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