BUPROPION AND AMITRIPTYLINE IN THE TREATMENT OF DEPRESSED-PATIENTS

Abstract

Bupropion, a specific dopamine reuptake inhibitor was compared to amitriptyline in 2 multicenter studies involving 183 depressed outpatients and inpatients. Initial results from these ongoing studies provide additional evidence of the anti-depressant activity of bupropion. At the end of the treatment periods (6 wk for inpatients and 13 wk for outpatients), bupropion appeared to be at least as effective as amitriptyline. Bupropion exerted a slightly but nonsignificantly smaller overall therapeutic effect than amitriptyline during the first 4 wk of drug treatment. Slight weight loss and dopaminergic side effects, such as insomnia, nausea/vomiting and anorexia, were somewhat more common among bupropion-treated patients. Compared to bupropion, amitriptyline induced more weight gain and had more anticholinergic, antihistaminic and antiadrenergic side effects. In view of its numerous sites of action, amitriptyline does not appear to be the ideal antidepressant. It remains to be demonstrated whether bupropion has any advantage over secondary amine tricyclic antidepressant, such as nortriptyline and desipramine.