One of the few dopaminergic agents to be developed, the noradrenaline-dopamine reuptake inhibitor (NDRI) bupropion hydrochloride has been available in United States (but not Europe) for major depressive disorder since 1989. GlaxoSmithKline is currently conducting clinical trials with the extended release formation (Bupropion XL) and is planning to file an application in Europe to market bupropion XL for major depressive disorder.
According to Dr Papakostas, clinical studies reported at the ECNP indicate that bupropion XL given once-daily could be an important option for the treatment of patients with moderate to severe major depressive disorder.
“Furthermore, while shown to be as effective as the SSRI escitalopram, treatment with bupropion XL does not appear to be associated with sexual side effects or sedation that patients often experience during treatment with the SSRIs,” said Dr Papakostas.
In a randomised, double-blind, placebo-controlled study, investigators evaluated the efficacy of bupropion XL 300 to 450 mg per day in 274 adult outpatients with major depression characterised by loss of pleasure, interest and energy for eight weeks.
Patients were enrolled in the study with a Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) diagnosis of major depression and Inventory of Depressive Symptomatology (IDS) score of seven on the general interest, energy, pleasure, sexual interest and physical energy items. Investigators used IDS-Self Report (IDS-SR) and IDS-Clinician Rated (IDS-C) questionnaires to assess each subject's change in depressive symptoms during the study.
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