The Effects of Bupropion on Residual and Cognitive Symptoms in SSRI-treated Depression
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Purpose
Many people with depression are treated with a serotonin-specific reuptake inhibitor anti-depressant (SSRI) and feel 'better'. Although many people feel 'better', they do not feel completely 'well'. Often, individuals continue to complain of cognitive problems such as lack of attention, diminished motivation, and impaired problem-solving. This study looks at whether residual and cognitive symptoms of depression in individuals are affected by the addition of bupropion.
| Condition | Intervention | Phase |
|---|---|---|
|
Depression Major Depressive Disorder Unipolar Depression |
Drug: bupropion |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | The Effects of Bupropion on Residual and Cognitive Symptoms in SSRI-treated Depression |
- Montgomery-Asberg Depression Rating Scale (MADRS) overall and question-specific scores [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
- neuropsychiatric assessment changes [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
- symptom self-report [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
- hyperactivity measures [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]
| Enrollment: | 30 |
| Study Start Date: | August 2005 |
| Study Completion Date: | December 2011 |
| Primary Completion Date: | January 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: 1
bupropion
|
Drug: bupropion
bupropion 150mg BID po
|
Detailed Description:
As many as 65-75% of treated patients continue to experience residual symptoms of depression. Cognitive impairments feature frontal cognitive dysfunction. Many experts believe that executive functions are better predictors of functional level than psychiatric diagnoses.
Frontal cognitive impairment and changes in neuroimaging are seen in individuals depleted of tryptophan, a serotonin precursor. These cognitive changes do not improve following serotonin-specific reuptake inhibitor treatment and at least one study has found that executive dysfunction predicts non-response to fluoxetine. In many patients, remission of mood symptoms in depression requires medications to target non-serotonergic neurotransmitter systems. Brain areas mediating executive functions receive rich noradrenergic inputs, and norepinephrine is known to be intimately involved in many of the executive functions.
A better understanding of serotonergic and catecholaminergic interactions would enable evidence-based treatment of depression which maximizes executive cognitive functions. This study examines the hypothesis that individuals treated with bupropion will have higher scores on tests of executive functions and lower scores on depression indices.
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Depression
- SSRI-treated
Exclusion Criteria:
- Bipolar disorder
- Serotonin-norepinephrine reuptake inhibitor (SNRI) or bupropion treatment
- Treatment-resistant depression
- Seizure disorder
- Bulimia or anorexia nervosa
- Pregnancy
Contacts and Locations| United States, Massachusetts | |
| McLean Hospital | |
| Belmont, Massachusetts, United States, 02478 | |
| Principal Investigator: | Beth L Murphy, MD, PhD | Mclean Hospital |
More Information
Additional Information:
No publications provided
| Responsible Party: | Beth L. Murphy MD, PhD, Principal Investigator, Mclean Hospital |
| ClinicalTrials.gov Identifier: | NCT00125957 History of Changes |
| Other Study ID Numbers: | 2005P-000502 |
| Study First Received: | August 1, 2005 |
| Last Updated: | April 20, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Mclean Hospital:
|
depression serotonin norepinephrine SSRI |
bupropion executive function residual symptoms |
Additional relevant MeSH terms:
|
Depression Depressive Disorder Depressive Disorder, Major Neurobehavioral Manifestations Behavioral Symptoms Mood Disorders Mental Disorders Neurologic Manifestations Nervous System Diseases Signs and Symptoms Bupropion Antidepressive Agents, Second-Generation |
Antidepressive Agents Psychotropic Drugs Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Dopamine Uptake Inhibitors Dopamine Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Neurotransmitter Uptake Inhibitors Physiological Effects of Drugs |
ClinicalTrials.gov processed this record on May 21, 2013