title: Double-blind comparison of bupropion and fluoxetine in depressed outpatients.
abstract: BACKGROUND
  This study was undertaken to compare the efficacy and safety of bupropion and fluoxetine.
  
  
  METHODS
  Moderately to severely depressed outpatients who fulfilled the DSM-III-R criteria for nonpsychotic major depressive disorder and had a score of 20 or more on the Hamilton Rating Scale for Depression (21 item) participated in this two-center study. Following a 1-week placebo phase, patients were randomly assigned to receive either bupropion or fluoxetine for 6 weeks of double-blind treatment. Weekly efficacy assessments included Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety, Clinical Global Impressions-Severity, and Clinical Global Impressions-Improvement. Vital signs and adverse experiences were also assessed weekly.
  
  
  RESULTS
  A total of 61 patients were randomly assigned to receive bupropion (225-450 mg/day) and 62 were randomly assigned to receive fluoxetine (20-80 mg/day). The mean daily dose at the end of the study was 382 mg/day for the bupropion treatment group and 38 mg/day for the fluoxetine treatment group. There were no statistically significant differences between treatments on any of the efficacy variables. On the basis of a 50% or greater reduction in the HAM-D scores, 63% (N = 37) of the bupropion-treated and 58% (N = 35) of the fluoxetine-treated patients were categorized as responders, and on the basis of CGI scores, 68% (N = 40) of the bupropion-treated and 58% (N = 35) of the fluoxetine-treated patients were rated as much or very much improved. HAM-A scores decreased by 59% for both treatment groups. The incidence of treatment-emergent adverse events was low with no statistically significant differences between treatments. Twenty-six percent (N = 16) of the bupropion-treated and 29% (N = 18) of the fluoxetine-treated patients prematurely discontinued treatment.
  
  
  CONCLUSIONS
  Both bupropion and fluoxetine demonstrated similar efficacy in relieving depression and accompanying symptoms of anxiety, and both exhibited a similar, favorable safety profile.
authors.affiliation: Feighner Research Institute, San Diego, Calif.
authors.forename: J P
authors.initials: JP
authors.lastname: Feighner
authors.forename: E A
authors.initials: EA
authors.lastname: Gardner
authors.forename: J A
authors.initials: JA
authors.lastname: Johnston
authors.forename: S R
authors.initials: SR
authors.lastname: Batey
authors.forename: M A
authors.initials: MA
authors.lastname: Khayrallah
authors.forename: J A
authors.initials: JA
authors.lastname: Ascher
authors.forename: C G
authors.initials: CG
authors.lastname: Lineberry
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D016642:Bupropion; D003866:Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010352:Patient Dropouts; D010555:Personality Inventory; D010919:Placebos; D011427:Propiophenones / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales
chemical_list: D000928:Antidepressive Agents; D010919:Placebos; D011427:Propiophenones; D005473:Fluoxetine; D016642:Bupropion