Description of the goods or services required
The Health Technology Assessment Programme is accepting stage 1 applications to their commissioned workstream for this primary research topic:
19/42 Selective serotonin reuptake inhibitor to prevent depression following traumatic brain injury
Traumatic brain injury (TBI) involves a degree of brain damage or dysfunction, even if only temporary. It is a heterogeneous condition but common to all presentations is that damage to the brain occurs because of external forces. TBI is a common cause of disability in the UK and the risk of developing depression within the months following injury is high. Studies have shown that depression after TBI can have a negative impact on family functioning, interpersonal relationships, quality of life, rehabilitation, and the ability to return to work. According to the Scottish Intercollegiate Guidelines Network, levels of disability a year after head injury are significantly related to psychological disorders rather than physical impairment, highlighting the need to directly address the problem.
Prophylactic use of antidepressants to prevent depression after TBI has been proposed as a possible strategy to help reduce the disease burden, and the drugs may already be prescribed in clinical practice for low mood despite little evidence. Promising findings from small studies carried out in the US have suggested that initiating a course of an SSRI to non-depressed people within a few weeks of TBI can significantly reduce the incidence of depression. This conclusion is consistent with meta-analyses of trials conducted in stroke patients that reported the effectiveness of prophylactic antidepressants at reducing the risk of depression after stroke: early initiation, longer duration of treatment (e.g. one year) and the use of an SSRI were associated with a significant reduction in the risk of post-stroke depression. A high quality, UK, multi-centre trial is needed to establish the effectiveness, or otherwise, of prophylactic antidepressants for preventing depression after TBI.