Antidepressants are being trialled to investigate whether they can prevent depression from developing in people who have suffered a head injury. A small US study showed that use of a widely used antidepressant in the weeks after an injury could help prevent severe depression. The much larger 18-month UK trial is examining early use of antidepressants following head trauma in 500 patients across nine UK major trauma centres. The study is measuring depression, quality of life and cognitive functioning, with results expected in 2027.
Around half of all people admitted to hospital with a head injury report major depression in the year following the accident, a rate 10 times higher than the general population. The trial aims to prevent depression occurring in the first place. Prior to this, much of the research on depression was focused on the treatment of depression once it had set in, which is known to be a difficult challenge. Lead researcher Khalida Ismail, professor of psychiatry and medicine at King’s College London, stressed a wider approach to addressing depression could benefit the NHS and wider economy. Brain injuries cost the UK over £15bn each year.
For many who have suffered a traumatic brain injury, physical recovery is often just the start of the problem. Depression and other mental health disorders, including anxiety, mood swings, memory and emotional control concerns, can also arise. However, many victims of traumatic brain injuries are typically slow to receive attention and medication. This results in increased depression, weight gain, and self-neglect. As a result, healthcare professionals hope the trial will reveal if the widely used antidepressants will become a preventative measure for depression after head injuries.
A consultant neuropsychiatrist, Dr Mike Dilley, from King’s College Hospital, reported that patients who came to see him about their brain injury are typically more concerned about their anxiety, mood, and memory problems than about physical difficulties. The precise methods by which the antidepressants under investigation, selective serotonin reuptake inhibitors (SSRIs), work remains unknown. Nonetheless, early results showed that SSRIs could reduce the effects of severe depression in some cases. As SSRIs may reduce brain inflammation, one theory suggests that they might trigger an anti-inflammatory response and protect the patients from longer-term harm
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