Last year, we reviewed a meta-analysis implying that bupropion is as effective as SSRIs for the treatment of patients with mixed anxi- ety and depression (TCPR, Aug 2007). In a new paper, these same researchers have sliced and diced the data a bit differently in order to answer this topic more confidently. Inapooledanalysisof10tri- als, researchers found that patients with anxious depression had a higher response rate when taking an SSRI as opposed to bupropion for both depression (65.4% vs. 59.4%) and anxiety (61.5% vs. 54.5%), as measured by the Hamilton Rating Scale for Depression (HAM-D) and the Hamilton Rating Scale for Anxiety (HAM-A). These differences were statistically significant. There was also a statistically significant, but very small, difference favoring SSRIs over bupropion on the mean HAM-D score. For nonanxious depression, there were no differences in treatment outcomes between patients taking bupropion and those taking SSRIs. (Papakostas GI et al., J Clin Psychiatry; Published online ahead of print).
TCPR’sTake: Foranxiousdepression,thisisthelargestcom- parisonbetweenbupropionandSSRIs. Theclinicalrelevanceof the results is certainly questionable, as the average patient taking an SSRI fared less than a single point better on the HAM-D relative to the average patient taking bupropion. There were no differences between SSRI and bupropion in terms of remission rates for depressionoranxiety. Basedonthesefindings,SSRIsappearto possess, at most, a very slight advantage over bupropion for anx- iousdepression. Alltrialsincludedintheanalysisweresponsored by GlaxoSmithKline, manufacturer of bupropion.
1 in 3 Americans were victims of online scams in the past year. Even when you know your patient is being scammed, it is hard to pull them out. We speak with Cathy Wilson about...
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