Remission Rates Following Antidepressant Therapy With Bupropion or Selective Serotonin Reuptake Inhibitors

Pilot Randomized Clinical Trial of an SSRI vs Bupropion: Effects on Suicidal Behavior, Ideation, and Mood in Major Depression

“…The 32% acute-phase attrition rate is in line with the average 33% rate found in four other 8-week bupropion vs SSRI randomized trials in MDD (N ¼ 1011) (Thase et al, 2005). The lack of differential drug effects that we observed during the continuation phase may be explained by the high cumulative 6-month attrition, and low variance in ideation because of robust acute improvement.…”

“…SSRIs primarily enhance serotonin neurotransmission whereas bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) with minimal (or no) direct effects on serotonin (Baldessarini, 2006). Similar antidepressant efficacy of these drugs (Thase et al, 2005;Gartlehner et al, 2008;Cipriani et al, 2009), and their relative safety on overdose, facilitates comparison of effects on suicidal ideation or behavior.…”

Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings

“…Other examples of DA agents effective in the treatment of MDD include the selective D 2 /D 3 receptor agonists pramipexole [292] and piribedil [293] the catechol-O-methyltransferase inhibitor tolcapone, [294], and the preferential presynaptic DA antagonist amisulpride, [295]. 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]. Tremblay and colleagues [226] reported that depressed patients had relatively greater increases in striatal and orbitofrontal cortex activation in response to emotional pictures after administration of dextroamphetamine (a stimulant associated with increased DA release).…”

The Controversy Over Antidepressant Drugs in an Era of Evidence-Based Practice

“…In Psychiatric Times, Thase (2002), debating with Kirsch in print, acknowledges that only one to two very-depressed persons of every 10 prescribed an SSRI get a "substantial benefit," but argues that from a public health perspective, that means many people are being helped. It is further acknowledged that only 2/3 of patients in eight week drug trials achieve a 50% reduction in their symptoms (Thase et al, 2005;Tranter, O'Donovan, Chandarana, & Kennedy, 2002). Only 40% of patients on active drug achieve remission during the eight week trial according to both Nemeroff, another recognized expert in the field of treatment of Major Depression (2011) and Thase et al (2005).…”

“…It is further acknowledged that only 2/3 of patients in eight week drug trials achieve a 50% reduction in their symptoms (Thase et al, 2005;Tranter, O'Donovan, Chandarana, & Kennedy, 2002). Only 40% of patients on active drug achieve remission during the eight week trial according to both Nemeroff, another recognized expert in the field of treatment of Major Depression (2011) and Thase et al (2005). According to DeRubeis, Fournier, and Fawcett (2010) examining data from the National Institute of Mental Health Collaborative Depression Study, the remission rates broken down by disease severity are:…”