Resolution of sleepiness and fatigue in major depressive disorder: A comparison of bupropion and the selective serotonin reuptake inhibitors.

Abstract

BACKGROUND:

The purpose of this study was to examine whether the treatment of major depressive disorder (MDD) with the norepinephrine-dopamine reuptake inhibitor (NDRI) bupropion results in a greater resolution of sleepiness and fatigue than with the selective serotonin reuptake inhibitors (SSRIs).

METHODS:

Six double-blind, randomized clinical trials comparing bupropion (n = 662) with an SSRI (n = 655) for the treatment of MDD were pooled. Hypersomnia scores were defined as the sum of scores of the Hamilton Depression Rating Scale (HDRS) items #22, 23, and 24. Fatigue scores were defined as the score of HDRS item #13.

RESULTS:

There was a greater improvement in hypersomnia scores among bupropion-treated than SSRI-treated (p < .0001) or placebo-treated patients (p = .0008). There was also a greater improvement in fatigue scores among bupropion-treated (p < .0001) and SSRI-treated (p = .0005) than placebo-treated patients as well as a greater improvement in fatigue scores among bupropion-treated than SSRI-treated patients (p = .0078). Fewer bupropion-remitters than SSRI-remitters experienced residual hypersomnia (20.5% vs. 32.1%; p = .0014) or residual fatigue (19.5% vs. 30.2%; p = .0020).

CONCLUSION:

Treatment of MDD with the NDRI bupropion resulted in a greater resolution of sleepiness and fatigue than SSRIs treatment. Although preliminary, these results warrant prospectively designed studies examining potential differences between bupropion and the SSRIs on these specific depressive symptoms.

• Authors: George I Papakostas, David J Nutt, Lindsay A Hallett, Vivian L Tucker, Alok Krishen, Maurizio Fava
• Journal: Biological psychiatry (Biol Psychiatry) Vol. 60 Issue 12 Pg. 1350-5 (Dec 15 2006) ISSN: 0006-3223 [Print] United States
• PMID: 16934768 (Publication Type: Comparative Study, Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Review)

Chemical References

• Dopamine Uptake Inhibitors
• Serotonin Uptake Inhibitors
• Bupropion

Topics

• Adult
• Aged
• Bupropion (therapeutic use)
• Depressive Disorder, Major (complications, drug therapy, psychology)
• Disorders of Excessive Somnolence (drug therapy, etiology, psychology)
• Dopamine Uptake Inhibitors (therapeutic use)
• Double-Blind Method
• Female
• Humans
• Male
• Mental Fatigue (drug therapy, etiology, psychology)
• Middle Aged
• Psychiatric Status Rating Scales
• Randomized Controlled Trials as Topic
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Terminology as Topic