Acute and Long-Term Bupropion Therapy: Response and Side Effects

AbstractPatients meeting DSM-III-R criteria for major depressive disorder were begun on bupropion with increases to a maximum of 450 mg/day. Fifteen of 23 patients in the acute study had at least a 50% fall in the Beck Depression Inventory (BDI) after a mean of 4.6 weeks (27% within 2 weeks). Thirteen (57%) had side effects, but none involved major adverse events, requiring discontinuation or reduction in dose. Onset of side effects preceeded clinical response (p = 0.05). Side effects were not related to dose or blood level. Long-term follow-up of 25 patients who responded for 12.0 ± 5.7 months was associated with a plateau at 2 months, with duration of side effects of 2.2 ± 2.8 months, and with relapse in only one patient (4%), who developed a blood level of 107 ng/mL and regained remission on reduction of dosage. Thus, bupropion is an effective acute and long-term treatment for depression with stabilization after 2 months, and with few side effects that may occur prior to clinical response but resolve q...