A placebo controlled treatment trial of sertraline and interpersonal psychotherapy for postpartum depression

J Affect Disord. 2019 Feb 15;245:524-532. doi: 10.1016/j.jad.2018.10.361. Epub 2018 Oct 31.

Abstract

Background: The purpose of the present study was to test the efficacy of sertraline and Interpersonal Psychotherapy (IPT) relative to pill placebo in a two site randomized controlled trial over a period of 12 weeks. It was hypothesized that sertraline and IPT would be more efficacious than pill placebo with respect to depression and social adjustment.

Methods: 162 breastfeeding and non-breastfeeding women experiencing a major depressive episode in the first year postpartum from two sites in Iowa and Rhode Island were randomly assigned to IPT, sertraline-clinical management (CM), or pill placebo-CM. CM included infant-focused psychoeducation. Interview-based and self-report measures of depression and social adjustment were obtained at baseline, 4-weeks, 8-weeks, and 12-weeks of treatment. Linear mixed effects regression (LMER) was used for the longitudinal data analysis.

Results: There was no significant effect for treatment condition associated with the primary outcome measure, the HamD-17, but there was a significant effect for sertraline-CM relative to the IPT and placebo conditions over the duration of the trial based on the General Depression scale of the Inventory of Depression and Anxiety Symptoms. There was a main effect for time in that study subjects across all three conditions showed significant improvement for the duration of the trial.

Limitations: Limitations of the present study included significant non-engagement with assigned condition and differential effects of IPT across the two study sites.

Conclusions: There was improvement for all postpartum women in all conditions. The results do suggest that active interventions with or without medication delivered over a period of twelve weeks can lead to significant improvement in depression and social adjustment among postpartum women. ClinicalTrials.gov identifier: NCT00602355.

Keywords: Breastfeeding; Clinical trial; Interpersonal psychotherapy; Postpartum depression; Sertraline.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Breast Feeding
  • Combined Modality Therapy
  • Depression, Postpartum / drug therapy
  • Depression, Postpartum / therapy*
  • Female
  • Humans
  • Iowa
  • Male
  • Person-Centered Psychotherapy / methods*
  • Postpartum Period / psychology
  • Psychiatric Status Rating Scales
  • Rhode Island
  • Sertraline / therapeutic use*
  • Treatment Outcome
  • Young Adult

Substances

  • Sertraline

Associated data

  • ClinicalTrials.gov/NCT00602355