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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic fatigue syndrome (CFS) includes many symptoms of major depression. For this reason, many antidepressants have been used to treat the symptoms of this disorder. Among the more recently released antidepressants are fluoxetine and bupropion. In this open study, nine CFS patients who either could not tolerate or did not respond to fluoxetine showed significant response when administered 300 mg/day of bupropion for an 8-week period in both rating of HDRS (t = 4.80, p < 0.01) and BDI (t = 2.48, p < 0.05). Furthermore, bupropion improvement in Hamilton Depression Rating Scale correlated significantly with change in plasma homovanillic acid (HVA) (r = 0.96, p < 0.01). Plasma total methylhydroxyphenolglycol (MHPG) also increased significantly during bupropion treatment (t = 2.37, p = 0.05). Measures of T1 microsomal antibodies also decreased over treatment time; increases in natural killer cell numbers correlated inversely with change in plasma levels of free MHPG (r = -0.88, p < 0.05). Bupropion responders were more likely to have trough blood levels above 30 ng/ml (chi 2 = 3.6, p = 0.05).
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PMID:Bupropion treatment of fluoxetine-resistant chronic fatigue syndrome. 145 Feb 97

Bupropion is a new antidepressant medicine that is chemically distinct from previous agents. Clinical studies have shown it to be as effective as the standard antidepressant drugs currently used in the treatment of major depression. It is useful in patients resistant to other agents as well as in patients with atypical depression. Bupropion is 10 to 100 times less likely to induce cardiac conduction problems than the tricyclic drugs, and orthostatic hypotension is rare. Minimal anticholinergic effects account for its being generally well tolerated. The most common side effect is dry mouth. An epileptogenic potential is prominently reported. Because it may lower the convulsive threshold, bupropion is not recommended for individuals who may be predisposed to seizures. In people without an increased ictal risk factor, and when dosage is maintained at 450 mg/day or less in a divided schedule, the seizure rate is comparable to that of other antidepressant drugs.
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PMID:Bupropion: overview and prescribing guidelines in depression. 189 94

Two hundred twenty-four outpatients with major depression entered a 6-week, five-center, double-blind trial of bupropion 300 mg/day and placebo. A total of 216 patients were included in the efficacy analysis. In the combined center analysis, greater efficacy for bupropion was found on one or more measures (Hamilton Rating Scale for Depression, Montgomery-Asberg Depression Rating Scale, and Clinical Global Impressions) at treatment Days 21, 28, 35, and 42. Bupropion was well tolerated; only four adverse events were reported at least 5% more often in the bupropion group than in the placebo group. Six bupropion patients versus 5 placebo patients discontinued treatment because of adverse events. This study extends earlier findings of efficacy for higher-dose treatment in an inpatient population to lower-dose treatment in an outpatient population.
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PMID:A fixed-dose (300 mg) efficacy study of bupropion and placebo in depressed outpatients. 211 May 59

Bupropion hydrochloride is a new monocyclic antidepressant. In humans, its disposition results in the formation of three major metabolites: the morpholinol metabolite, the erythroamino alcohol, and the threoamino alcohol metabolite. Bupropion's disposition was monitored following a single oral 200 mg dose in eight healthy volunteers and eight age- (44.5 +/- 8.4 years) and weight- (77.4 +/- 6.7 kg) matched volunteers with alcoholic liver disease. This latter group is of interest because the incidence of depression is more frequent in alcoholics than in the general population, and the liver is the major route of elimination for cyclic antidepressants. The mean elimination half-life of the morpholinol metabolite was significantly prolonged in subjects with alcoholic liver disease (32.2 +/- 13.5 vs. 21.1 +/- 4.9 hours (p less than 0.05), while the differences in bupropion (17.3 +/- 8.6 hours vs. 16.5 +/- 10.4 hours for healthy subjects and subjects with alcoholic liver disease, respectively), erythroamino alcohol (26.1 +/- 13.3 hours vs. 29.8 +/- 6.9 hours for healthy subjects and subjects with alcoholic liver disease, respectively), and threoamino alcohol (25.5 +/- 8.6 hours vs. 23.4 +/- 10.7 hours for healthy subjects and subjects with alcoholic liver disease, respectively) were minimal. Mean area under the plasma concentration time curves for bupropion and metabolites were increased in subjects with alcoholic liver disease; however, clear differences between means of these small groups did not emerge, probably due to the increased variability of bupropion pharmacokinetics in these subjects. As a therapeutic agent for the treatment of depression in chronic alcoholics who may consume alcohol in combination with their antidepressant therapy, the lack of sedation with bupropion could be advantageous.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disposition of bupropion in healthy volunteers and subjects with alcoholic liver disease. 212 17

Bupropion, a new nontricyclic antidepressant, was administered clinically on an open basis to 40 male outpatients at doses of 300 to 600 mg/day for 4 to 26 months. Of these, 12 patients had no history of sexual dysfunction, whereas 28 patients reported a history of significant sexual dysfunction (impaired libido, partial erection) while receiving tricyclic, monoamine oxidase inhibitor, maprotiline, and trazodone antidepressants. The adverse sexual effects resolved in 24 of the 28 patients (p less than 0.001) when they were transferred to bupropion. Of the four patients who failed to improve sexually on bupropion, two were diabetic and the other two had lifelong impairments in sexual functioning that were probably unrelated to drugs or depression. The 12 patients who had a negative history of sexual dysfunction continued to have normal sexual functioning during bupropion treatment. Based upon bupropion's lack of anticholinergic and antiadrenergic effects and the clinical observations in this study, this antidepressant appears to have a very low propensity for inducing adverse sexual side effects.
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PMID:Bupropion--an antidepressant without sexual pathophysiological action. 391 69

The chemistry, pharmacokinetics, pharmacology, clinical efficacy, adverse effects, and dosage of bupropion hydrochloride, an aminoketone antidepressant, are reviewed. Bupropion is rapidly absorbed after oral administration and demonstrates a first-order absorptive phase. Bupropion has biphasic elimination with a redistribution half-life of about one hour and an elimination half-life of 11-14 hours. Bupropion is widely distributed to tissues and extensively metabolized by oxidation and reduction to at least six metabolites, some of which may be active. Bupropion does not inhibit monoamine oxidase, exerts no effect on serotonin uptake, and minimally alters the reuptake of norepinephrine at presynaptic sites. It does not appear to exert action leading to postsynaptic beta-adrenergic down-regulation, and it has minimal inhibitory effects on presynaptic dopamine uptake. Bupropion has been shown to be as effective as tricyclic antidepressants (TCAs), with particularly well-documented efficacy in depressed patients with manic-depressive illness in several controlled clinical trials. Bupropion causes fewer anticholinergic, orthostatic, and cardiac conductive side effects than TCAs. Elderly patients may be given full adult doses of bupropion, and preliminary experience with overdoses suggests that it is a relatively safe drug for patients with suicidal ideation. The usual adult daily dose of bupropion hydrochloride is 300-750 mg, depending on the severity of the depression. In all cases, bupropion should be given in three doses daily. Bupropion is an effective antidepressant with a good side-effect profile; it is a useful alternative for patients unresponsive to or intolerant of therapeutic doses of TCAs.
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PMID:Review of bupropion. 614 95

Results of four multicenter randomized double-blind placebo-controlled studies of the antidepressant efficacy and safety of bupropion are reviewed. Bupropion was superior to placebo on the Hamilton Depression and Anxiety Rating Scales, Clinical Global Impressions-Improvement, and patient self-rating scales (Zung) for depression and anxiety. Overall, the proportion of patients responding to bupropion was typically 60%-70%, compared to approximately 30% for placebo. Drug-placebo differences became apparent at 5 days to 3 weeks after treatment initiation. With respect to subjective side effects, bupropion exhibited a profile very similar to that of placebo. Further, no clinically significant cardiovascular or clinical laboratory changes were noted. Bupropion appears to be an effective broad-spectrum antidepressant with an excellent side effect profile.
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PMID:Review of placebo-controlled trials with bupropion. 640 36

Bupropion and amitriptyline were compared in a double-blind study of depressed inpatients. Treatment ranged from 2 to 4 weeks: early responders (Hamilton Depression Scale scores less than 10) were often removed from treatment after 2 or 3 weeks. Twenty-two patients completed treatment with bupropion and 18 with amitriptyline. Doses ranged from 450 to 750 mg/day for bupropion and 75 to 225 mg/day for amitriptyline. Overall, bupropion and amitriptyline were equally effective, as measured by the Hamilton Depression and Anxiety scales, Clinical Global Impressions, Zung Depression scale, and the SCL-90. Differences in the side effect profile and in weight change are described.
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PMID:A double-blind comparison of bupropion and amitriptyline in depressed inpatients. 640 38

A multicenter uncontrolled 4-week trial of bupropion in depressed outpatients was conducted in the private practices of 25 internists, 9 family practitioners, and 3 psychiatrists. Minimum exclusion criteria were used with respect to concurrent medical ailments, age, and concomitant medications. Of the 380 patients admitted to the study, 325 were included in efficacy analyses, and 359 provided data for safety analyses. The average patient was a 51-year-old married white woman with a high school education and a skilled job. Bupropion administered in doses of 150-450 mg/day was highly effective in reducing depressive symptomatology as evaluated by the Hamilton Depression and Clinical Global Impressions scales, and the Zung Self-Rating Scale. No clinically significant bupropion-related changes in blood pressure, pulse rates, respiration rate, body temperature, or laboratory parameters were recorded; only 41 patients were discontinued due to intolerance to adverse experiences. There was a notable absence of daytime sedation, and of anticholinergic and cardiovascular side effects.
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PMID:Private practice evaluation of the safety and efficacy of bupropion in depressed outpatients. 640 46

Bupropion is a novel, structurally unique (single ring) compound, radically different from tricyclic antidepressants in its pharmacologic profile. In a random assignment, double-blind, long-term follow-up study of 60 depressed in- and outpatients (DSM-III criteria) in eight centers, the antidepressant actions of bupropion and amitriptyline were compared. Bupropion was as effective as amitriptyline in reducing depressive symptoms over a 6-month period, as measured by Hamilton depression and anxiety scales and Clinical Global Impression scores. Unlike amitriptyline, bupropion did not increase uric acid or cholesterol levels, and was not associated with weight gain. Bupropion was better tolerated than amitriptyline, the most commonly prescribed antidepressant.
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PMID:Long-term efficacy and safety of bupropion. 640 48


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