Depression Clinical Trial
Official title:
Prevention of Recurrent Postpartum Depression
This study will determine the effectiveness of taking sertraline within 24 hours of giving birth in preventing a recurrence of postpartum depression.
Depression after pregnancy is called postpartum depression and may be caused by a rapid
change in hormone levels during and immediately after pregnancy. Researchers believe that it
is one of the most common complications linked to pregnancy. This type of depression occurs
in 10 to 15% of women within the first 3 months of giving birth and it can negatively affect
both mothers and their children. Mothers with postpartum depression may experience low
energy, difficulty concentrating, irritability, and inability to meet their children's needs
for love and affection. Research shows that children of mothers with postpartum depression
may have delays in language development, difficulty with emotional bonding to others,
behavioral problems, lower activity levels, sleep problems, and distress. Many women who
have suffered from postpartum depression in the past are worried about a repeat episode with
the birth of their next baby. This study will determine the effectiveness of taking
sertraline within 24 hours of giving birth in preventing a recurrence of postpartum
depression.
Participants in this double blind study will initially report to the study site two separate
times while they are pregnant. At the first visit, which will last approximately 3 hours,
medical and psychiatric histories will be taken. Blood and urine samples will also be
collected at this time. At the second visit, which will last approximately 1 hour,
participants will be randomly assigned to receive either sertraline or placebo for the year
following childbirth. All participants will then either attend 10 clinic visits, each
lasting 1 hour, or receive 17 phone calls over the course of the first 28 weeks postpartum.
Mood symptoms and day-to-day functioning will be assessed. If the participant's baby is
being breastfed, a blood sample will also be taken from the baby at Week 4 postpartum. At
Week 12 postpartum, the baby will wear an actigraph to measure his or her activity for one
week. At Week 24 postpartum, participants who are not depressed will be randomly assigned to
either continue on sertraline or taper to placebo over 4 weeks. Those who were originally
assigned to receive placebo will continue taking placebo for the remainder of the study.
Starting at Week 29 postpartum, there will be approximately one clinic visit per month for
the remainder of the year. Participants' functioning, ability to interact with their
children, and symptoms of depression will be assessed at these visits.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Prevention
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