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The combination of duloxetine and bupropion for treatment‐resistant major depressive disorder
Author(s) -
Papakostas George I.,
Worthington John J.,
Iosifescu Dan V.,
Kinrys Gustavo,
Burns Alana M.,
Fisher Lauren B.,
Homberger Caitlin H.,
Mischoulon David,
Fava Maurizio
Publication year - 2006
Publication title -
depression and anxiety
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.634
H-Index - 129
eISSN - 1520-6394
pISSN - 1091-4269
DOI - 10.1002/da.20181
Subject(s) - bupropion , duloxetine , major depressive disorder , medicine , nausea , antidepressant , duloxetine hydrochloride , adjunctive treatment , anesthesia , alternative medicine , pathology , smoking cessation , hippocampus , amygdala
Our objective was to assess the effectiveness and safety of the combination of duloxetine and bupropion for treatment‐resistant major depressive disorder (TRD). A retrospective chart review was conducted to identify patients with major depressive disorder (MDD) who had not experienced full remission of symptoms following an adequate trial of either duloxetine ( n =3) or bupropion ( n =7), and who then received the combination of these two antidepressants for TRD. Ten patients [37.2±11.3 years of age, five women, baseline Clinical Global Impressions (CGI) scale score 4.4±1.1], seven of whom had not remitted following treatment with bupropion (330±67 mg, 20.5±12.2 weeks), and three of whom had not remitted following treatment with duloxetine (90±30 mg, 18±2 weeks) received at least 4 weeks of combination treatment. The CGI was administered when the combination was first prescribed, and following 8.8±4.0 (range, 4–16) weeks of treatment. There was a significant decrease in CGI‐S (Severity) scores (4.4±1.1 to 2.1±0.9, P <.0001) following combination treatment. Three (30%) patients were remitters at follow‐up, and six (60%) were responders who did not achieve full symptom remission. The mean maximum adjunctive duloxetine and bupropion doses were 60.0±17.3 mg and 175.0±114.5 mg, respectively. Side effects reported during combination treatment were nausea ( n =2), dry mouth ( n =2), jitteriness/agitation ( n =2), fatigue/drowsiness ( n =2), increased blood pressure ( n =1), increased sweating ( n =1), insomnia ( n =1), pruritus ( n =1), headache ( n =1), sexual dysfunction ( n =1), and weight gain ( n =1). Although preliminary, these results suggest a possible role for the combination of duloxetine and bupropion for TRD. Depression and Anxiety 23:178–181, 2006. © 2006 Wiley‐Liss, Inc.