Role of Sertraline in Post TBI Depression and Quality of Life in Traumatic Brain Injury

Abstract

IntroductionTBI is a major cause of disability. Depression is one of the major squeal of TBI in both inpatient and outpatient populations. Depression is associated with numerous negative outcome, thus affecting QOL adversely in these patients. Addressing depression in treatment regimen of TBI may improve QOL of these patients.ObjectivePresent study is designed to evaluate the role of sertraline in post TBI depression and its impact on QOL.MethodologyEighty male patients with post TBI depression were included in study amongst the 250 male patients of mild to moderate TBI recruited for evaluation. Half of the patients were given sertraline 50 mg PO whereas other half served as control without sertraline treatment. Participants were assessed on GCS, PHQ-9 and WHOQQOL at regular interval till the end of 6 months.ResultDepression was found in 35.6% of total patients recruited. Most of the patients (63.1%)were below 35 years of age. Depression was more common in mild TBI cases than those with moderate TBI(53.7% v/s 46.25%,p=0.04).Left side brain injury (56.25%)with cerebral contusions was more commonly associated with depression(p=0.04). Patients in sertraline group responded well to treatment with significant improvement in mod symptoms(PHQ-9 score 14.88±3.603 v/s 5.33±2.98,p=0.04)). All the four domains of QOL improved significantly in sertraline group than the control group with sertraline treatment.ConclusionManagement of TBI must focus on treatment of associated mood symptoms which is likely to be associated with poor QOL . Sertraline is effective in treatment of depression with significant improvement in QOL in TBI patients.