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Combining Serotonin Reuptake Inhibitors and Bupropion in Partial Responders to Antidepressant Monotherapy
Abstract
BACKGROUND: Many patients with affective illness show partial or otherwise unsatisfactory responses to standard treatments, encouraging trials of combinations of pharmacologically dissimilar antidepressants. METHOD: Records of consecutive outpatients with affective disorders only partially responsive to treatment with a serotonin reuptake inhibitor (SRI) or bupropion, alone, were reviewed for changes in specific symptoms and risks of adverse events when an SRI and bupropion were combined. RESULTS: Greater symptomatic improvement was found in 19 (70%) of 27 subjects during a mean +/- SD of 11 +/- 14 months of combined daily use of bupropion (243 +/- 99 mg) with an SRI (31 +/- 16 mg fluoxetine-equivalents) than with either agent alone. Adverse effect risks were similar to those associated with each monotherapy, with a > 10% incidence of sexual dysfunction (N = 11, 41%), insomnia (N = 6, 22%), anergy (N = 4, 15%), and tremor (N = 3, 11%) during combined therapy; there were no seizures. CONCLUSION: With conservative dosing and close monitoring, combinations of SRIs with bupropion in this uncontrolled clinical series appeared to be safe and often more effective than monotherapy.
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“Particularly relevant in the present context are previous reports [290,296,297] that although both DA and non-DA agents can be used to effectively treat mood disorders, DA agents generally have superior effects on symptoms of anhedonia, specifically when compared with non-DA agents [19,298-300].”
From Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings (2012) · cites this paper as [298]
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Metadata
- Authors
- Bodkin, J. A., Lasser, R. A., Wines, J. D., Gardner, D. M., & Baldessarini, R. J.
- Affiliations
- Harvard University (US)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 1997-04-15
- Volume
- 58
- Issue
- 4
- Pages
- 137-145
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W1982954842
- Cited by
- 159
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 4 · 2017: 4 · 2016: 2 · 2015: 2 · 2014: 3 · 2013: 1 · 2012: 6
- FWCI
- 7.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k05mh047370-25)
- National Institute of Mental Health (P01MH031154, MH-31154, MH47370)
- Topics
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- serotonin reuptake inhibitors, bupropion, antidepressant combination therapy, antidepressant monotherapy, mood disorders, adverse drug reactions, sexual dysfunction, insomnia, anergia, tremor, seizure risk
- MeSH terms
- Adult, Aged, Ambulatory Care, Anxiety Disorders, Depressive Disorder, Drug Administration Schedule, Drug Therapy, Combination, Epilepsy, Female, Fluoxetine, Humans, Male, Middle Aged, 1-Naphthylamine, Panic Disorder, Bupropion, Fluvoxamine, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Dysthymic Disorder, Sertraline
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