Bupropion sustained release versus paroxetine for the treatment of depression in the elderly

• Published in: The journal of clinical psychiatry Vol. 61; no. 3; pp. 196 - 202
• Main Authors: WEIHS, K. L, SETTLE, E. C, BATEY, S. R, HOUSER, T. L, DONAHUE, R. M. J, ASCHER, J. A
• Format: Journal Article
• Language: English
• Published: Memphis, TN Physicians Postgraduate Press 01-03-2000
• Subjects: Aged; Ambulatory Care; Antidepressive Agents, Second-Generation - administration & dosage; Antidepressive Agents, Second-Generation - adverse effects; Antidepressive Agents, Second-Generation - therapeutic use; Biological and medical sciences; Bupropion - administration & dosage; Bupropion - adverse effects; Bupropion - therapeutic use; Comorbidity; Delayed-Action Preparations; Depressive Disorder - diagnosis; Depressive Disorder - drug therapy; Depressive Disorder - psychology; Double-Blind Method; Female; Humans; Male; Medical sciences; Middle Aged; Neuropharmacology; Paroxetine - administration & dosage; Paroxetine - adverse effects; Paroxetine - therapeutic use; Pharmacology. Drug treatments; Psychiatric Status Rating Scales - statistics & numerical data; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Risk Factors; Seizures - chemically induced; Serotonin Uptake Inhibitors - administration & dosage; Serotonin Uptake Inhibitors - adverse effects; Serotonin Uptake Inhibitors - therapeutic use; Treatment Outcome; Human; Mood disorder; Paroxetine; Amfebutamone; Serotonin; Controlled release form; Psychotropic; Toxicity; Treatment efficiency; Depression; Reuptake inhibitor; Dose activity relation; Chemotherapy; Treatment; Follow up study; Piperidine derivatives; Dosage form; Antidepressant agent; Elderly; Comparative study
• ISSN: 0160-6689; 1555-2101
• DOI: 10.4088/JCP.v61n0309

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.
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.
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.
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.