Original articleResolution of Sleepiness and Fatigue in Major Depressive Disorder: A Comparison of Bupropion and the Selective Serotonin Reuptake Inhibitors
Section snippets
Methods and Materials
The present work involved pooling individual patient data from six double-blind, randomized clinical trials sponsored by GlaxoSmithKline (Research Triangle Park, North Carolina) comparing bupropion with an SSRI for the treatment of MDD that also included outcome measures for both hypersomnia and fatigue. Although to date (October 2005) a total of 10 studies sponsored by GlaxoSmithKline comparing bupropion with an SSRI for the treatment of MDD have been conducted, 4 of these studies were
Results
Baseline demographic and clinical characteristics of MDD patients enrolled in the six trials are reported in Table 2. There were no statistically significant differences in any of these variables at baseline between bupropion, SSRI, and placebo groups. The overall remission rates for three treatment groups were: bupropion: 46.5% (308 of 662); SSRIs: 48.7% (324 of 655); and placebo: 34.1% (167 of 489). Treatment with bupropion (p < .0001) and the SSRIs (p < .0001) resulted in greater remission
Discussion
The present work adds to a growing literature suggesting differences among antidepressant classes in their ability to resolve specific depressive symptoms (Fava et al 2005, Goldstein et al 2004, Winokur et al 2005). Pooling data from all available double-blind, randomized clinical trials comparing the NDRI bupropion with SSRIs for MDD revealed that treatment with bupropion resulted in a greater resolution of sleepiness and fatigue than SSRI treatment. This was true regardless of the degree of
Conclusion
Treatment of MDD with the NDRI bupropion resulted in a greater resolution of sleepiness and fatigue than SSRI treatment. Approximately one in five bupropion-remitters compared with nearly one in three SSRI-remitters experienced residual sleepiness and fatigue at end point. In light of studies linking a greater burden of residual symptoms of MDD with poorer psychosocial functioning and increased relapse rates, future studies should focus on the relationship between the resolution of fatigue and
References (43)
- et al.
Depressive disease: Classification and clinical characteristics
Compr Psychiatry
(1971) - et al.
A placebo-controlled comparison of the effects on sexual functioning of bupropion sustained release and fluoxetine
Clin Ther
(2001) - et al.
A placebo-controlled comparison of the antidepressant efficacy and effects on sexual functioning of sustained-release bupropion and sertraline
Clin Ther
(1999) - et al.
Definition and epidemiology of treatment-resistant depression
Psychiatr Clin North Am
(1996) - et al.
The validity of major depression with atypical features based on a community study
J Affect Disord
(1992) - et al.
A survey of prescribing practices in the treatment of depression
Prog Neuropsychopharmacol Biol Psychiatry
(2002) - et al.
Symptoms of atypical depression
Psychiatry Res
(2001) - et al.
Does pretreatment anxiety predict response to either bupropion SR or sertraline?
J Affect Disord
(2001) - et al.
Response in relation to baseline anxiety levels in major depressive disorder treated with bupropion sustained release or sertraline
Neuropsychopharmacol
(2001) - et al.
Recovery from depression, work productivity, and health care costs among primary care patients
Gen Hosp Psychiatry
(2000)
Bupropion: A review of its mechanism of antidepressant activity
J Clin Psychiatry
Teoria statistica delle classi e calcolo delle probabilità
Pubblicazioni del Istituto Superiore di Scienze Economiche e Commerciali di Firenze
Fixed-dose trial of the single isomer SSRI escitalopram in depressed outpatients
J Clin Psychiatry
Bupropion extended release compared with escitalopram: Effects on sexual functioning and antidepressant efficacy in 2 double-blind, placebo-controlled trials
J Clin Psychiatry
Sexual dysfunction associated with the treatment of depression: A placebo-controlled comparison of bupropion sustained release and sertraline treatment
Ann Clin Psychiatry
The many faces of fatigue in major depressive disorder
Int J Neuropsychopharmacol
Symptoms of fatigue and cognitive/executive dysfunction in major depressive disorder before and after antidepressant treatment
J Clin Psychiatry
Daytime sleepiness and insomnia as correlates of depression
J Clin Psychiatry
15 years of clinical experience with bupropion HCl: From bupropion to bupropion SR to bupropion XL
Prim Care Companion J Clin Psychiatry
Double-blind comparison of bupropion and fluoxetine in depressed outpatients
J Clin Psychiatry
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