A randomized, placebo-controlled, double-blind trial of sertraline for postpartum depression

Liisa Hantsoo, Deborah Ward-O'Brien, Kathryn A. Czarkowski, Ralitza Gueorguieva, Lawrence H. Price, C. Neill Epperson

Research output: Contribution to journalArticlepeer-review

43 Scopus citations


Rationale: Postpartum depression (PMD) occurs in roughly 10 % of postpartum women and negatively impacts the mother and her offspring, but there are few placebo-controlled studies of antidepressant treatment in this population. Objective: The objective was this study is to compare the selective serotonin reuptake inhibitor (SSRI) sertraline to placebo for treating PMD. Methods: This was a single-center, 6-week, randomized double-blind placebo-controlled trial of sertraline with a 1-week placebo lead-in. The participants (n = 38) were women with depression onset within 3 months of delivery; a subset (n = 27) met strict DSM-IV criteria for PMD (onset within 4 weeks of delivery). The participants were prescribed sertraline 50 mg or placebo daily to a maximum of 200 mg/day. Primary outcome variables were the Hamilton Depression Rating Scale (HAM-D) and Clinical Global Impressions (CGI) scores, which were used to determine the rates of response and remission. Results: Sertraline produced a significantly greater response rate (59 %) than placebo (26 %) and a more than twofold increased remission rate (53 % vs. 21 %). Mixed models did not reveal significant group by time effects, although in the subset of women who met the DSM-IV criteria, there was a statistically significant group by time effect for the HAM-D, Hamilton Anxiety Rating Scale (HAM-A), and CGI. Conclusions: Women with PMD are more likely to have a remission of their depression with sertraline treatment, a finding that is more pronounced in women who have onset of depression within 4 weeks of childbirth. These data support the continued use of 4 weeks for the DSM-5 postpartum onset specifier for major depressive disorder.

Original languageEnglish (US)
Pages (from-to)939-948
Number of pages10
Issue number5
StatePublished - Mar 2014
Externally publishedYes


  • Depression
  • Postpartum
  • Pregnancy
  • Puerperal
  • SSRI
  • Sertraline
  • Women

ASJC Scopus subject areas

  • Pharmacology


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