Abstract | BACKGROUND: METHOD: Individual patient data were pooled from a complete set of 7 randomized, double-blind studies comparing bupropion (N = 732) with SSRIs ( fluoxetine, N = 339; sertraline, N = 343; paroxetine, N = 49) in outpatients with major depressive disorder (DSM-III-R or DSM-IV); 4 studies included placebo (N = 512). Response and remission rates were compared at week 8 or endpoint in both the intent-to-treat sample, using the last-observation-carried-forward (LOCF) method to account for attrition, and the observed cases. Tolerability data, including incidence of sexual side effects, were also compared. RESULTS: The LOCF response and remission rates for the bupropion (62% and 47%) and SSRI (63% and 47%) groups were similar; both active therapies were superior to placebo (51% and 36%; all comparisons, p < .001). The same pattern of results was demonstrated on the observed cases analyses. Although bupropion and SSRIs were generally well tolerated, SSRI therapy resulted in significantly higher rates of sexual side effects as compared to both bupropion and placebo. SSRIs were also associated with more somnolence and diarrhea, and bupropion was associated with more dry mouth. CONCLUSION:
Bupropion and the SSRIs were equivalently effective and, overall, both treatments were well tolerated. The principal difference between these treatments was that sexual dysfunction commonly complicated SSRI therapy, whereas treatment with bupropion caused no more sexual dysfunction than placebo.
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Authors | Michael E Thase, Barbara R Haight, Nathalie Richard, Carol B Rockett, Melinda Mitton, Jack G Modell, Susan VanMeter, April E Harriett, Younghua Wang |
Journal | The Journal of clinical psychiatry
(J Clin Psychiatry)
Vol. 66
Issue 8
Pg. 974-81
(Aug 2005)
ISSN: 0160-6689 [Print] United States |
PMID | 16086611
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antidepressive Agents, Second-Generation
- Serotonin Uptake Inhibitors
- Bupropion
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Topics |
- Antidepressive Agents, Second-Generation
(therapeutic use)
- Bupropion
(therapeutic use)
- Depressive Disorder, Major
(drug therapy)
- Humans
- Randomized Controlled Trials as Topic
- Selective Serotonin Reuptake Inhibitors
(therapeutic use)
- Treatment Outcome
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