Bupropion Sustained Release Versus Paroxetine for the Treatment of Depression in the Elderly
Abstract
BACKGROUND: Depression is a serious and widespread emotional disorder among the elderly. This study compared the efficacy and safety of bupropion sustained release (SR) with the selective serotonin reuptake inhibitor paroxetine in the treatment of major depression in elderly outpatients. METHOD: Elderly (> or = 60 years) outpatients with major depressive disorder (DSM-IV criteria) were evaluated in this 6-week multicenter, randomized, double-blind study comparing bupropion SR, 100-300 mg/day, and paroxetine, 10-40 mg/day. Efficacy was assessed by changes in scores on the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A) and the Clinical Global Impressions-Severity of Illness and -Improvement scales. Safety was assessed by monitoring adverse events, vital signs, and body weight. RESULTS: A total of 100 patients ranging in age from 60 to 88 years were randomly assigned to treatment with bupropion SR (N = 48) or paroxetine (N = 52). Measurements of efficacy were similar between the 2 treatment groups, with both groups showing improved scores on all depression rating scales. Headache, insomnia, dry mouth, agitation, dizziness, and nausea occurred in > 10% of patients in both groups; somnolence, diarrhea, constipation, and anorexia occurred in > 10% of patients in the paroxetine group. No statistically significant differences between groups in vital signs or weight were found. CONCLUSION: Both bupropion SR and paroxetine were safe and effective for the treatment of depression in the elderly. Because of its favorable side effect profile, bupropion SR may provide a safe and effective nonserotonergic treatment alternative that is well suited as an antidepressant for the elderly.
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Although both DA and non-DA agents can effectively treat mood disorders, DA agents generally have superior effects on symptoms of anhedonia compared with non-DA agents.
“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 [297]
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Empfehlungen für Diagnostik und Therapie der Depression im Alter
Hatzinger, M., Hemmeter, U., Hirsbrunner, T., Holsboer‐Trachsler, E., Leyhe, T., Mall, J., Mosimann, U. P., Rach, N., Trächsel, N., & Savaskan, E. (2018) · Praxis · doi:10.1024/1661-8157/a002883 · Cited by 10 · see citing works
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Papakostas, G. I., & D, M. F. M. (2005) · Wiley eBooks · doi:10.1002/9783527619672.ch6 · Cited by 11 · see citing works
Approach to Pain in the Elderly
Ozturk, R. I. G. B., & Akpinar, T. S. (2013) · Journal of Gerontology & Geriatric Research · doi:10.4172/2167-7182.1000125 · Cited by 9 · see citing works
Efficacy of Bupropion XR in Treatment-Resistant Elderly Patients
Bergman, J., Miodownik, C., Palatnik, A., & Lerner, V. (2011) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e3182096f5a · Cited by 9 · see citing works
- Authors
- Weihs, K. L., Settle, E. C., Batey, S. R., Houser, T. L., Donahue, R. M. J., & Ascher, J. A.
- Affiliations
- George Washington University (US)
- GlaxoSmithKline (United Kingdom) (GB)
- ORCID
- Weihs, Karen L.
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2000-03-15
- Volume
- 61
- Issue
- 3
- Pages
- 196-202
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2018434620
- Cited by
- 150
- References
- 0
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 6 · 2013: 6 · 2012: 6
- FWCI
- 7.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- bupropion sustained release, paroxetine, major depressive disorder, geriatric depression, antidepressant efficacy, antidepressant safety, adverse drug reactions, selective serotonin reuptake inhibitors, outpatients
- MeSH terms
- Aged, Ambulatory Care, Delayed-Action Preparations, Depressive Disorder, Double-Blind Method, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Risk Factors, Seizures, Comorbidity, Bupropion, Treatment Outcome, Selective Serotonin Reuptake Inhibitors, Paroxetine, Antidepressive Agents, Second-Generation
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