OBJECTIVE: To undertake a systematic review and meta-analysis of pharmacological interventions for depression in people with traumatic brain injury.
METHOD: Searches were undertaken for randomised controlled trials of pharmacological interventions in people with depression and traumatic brain injury. Searches were carried out as per our protocol and studies that fulfilled our inclusion criteria were included in the meta-analysis.
RESULTS: Four studies were identified that fulfilled our inclusion criteria. Sertraline, desipramine, methylphenidate and modafinil were investigated in these studies. There were 72 participants in total in the intervention arm and 57 participants in the placebo arm. Meta-analysis showed favourable results for sertraline, desipramine and methylphenidate on outcomes measures for depressive symptoms. Only results for methylphenidate were statistically significant. Sertraline, methylphenidate and modafinil showed favourable results on quality of life indicators but results were not statistically significant. Sertraline showed favourable results on outcome measures for anxiety symptoms but results were not statistically significant.
CONCLUSION: Some pharmacological interventions appear to improve depressive symptoms, anxiety symptoms and quality of life in people with depression and traumatic brain injury. However, the evidence is limited. There is a paucity of evidence for the effectiveness of other pharmacological interventions used in depression in this particular patient group.