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.
Key Words
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Article info
Publication history
Published online: August 25, 2006
Accepted:
June 8,
2006
Received in revised form:
June 6,
2006
Received:
November 9,
2005
Identification
Copyright
© 2006 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
