2002 International International Biennial Scientific Meeting

SERTRALINE PREVENTS POSTPARTUM DEPRESSION

Katherine L Wisner*, Kathleen S Peindl, James M Perel, Barbara H Hanusa, Catherine M Piontek, and Robert L Findling

* Gottfried and Gisela Kolb Professor of Outpatient Psychiatry, Women's Mental HealthCARE, Louisville, Kentucky, USA

wisnerkl@msx.upmc.edu

Objective: Women who have suffered one episode of postpartum-onset major depression (PPMD) comprise a high-risk group for subsequent episodes. We conducted a double-blind, randomized clinical trial to test the efficacy of setraline (SERT) to prevent recurrent PPMD.

Methods: Non-depressed women who had at least one past episode of PPMD were recruited during pregnancy. The subject was assigned randomly to SERT or placebo (PL). Treatment began immediately postpartum. The subject was assessed for 20 sequential weeks with the Hamilton Rating Scale for Depression (HRSD) and the Structured Clinical Interview for DSM-IV to establish recurrence of major depression.

Results: In our sample of 22 women, there were 5 recurrences in the 17-week preventive treatment period; 4 of 8 (0.50, 95% exact CI=0.16 to 0.84) were taking PL and 1 of 14 was taking SERT (0.07, 95% exact CI=0.00 to 0.34); the difference is significant (Fisher's Exact p=0.04). The time to postpartum recurrence ranged from 4-17 weeks. The time to recurrence was significantly different between the SERT and PL treatments (Exact Wilcoxon-Gehan p=0.049).

Conclusions: SERT provided preventive efficacy for postpartum depression beyond that of PL.