Antidepressant response and plasma concentrations of bupropion.
A double-blind multicenter evaluation compared the antidepressant efficacy of bupropion (Wellbutrin) to both placebo and amitriptyline (Elavil, Endep) in adult patients who met DSM-III criteria for major depressive disorder. Steady-state plasma samples were obtained 11-12 hours and 4 hours after the last dose in 50 and 44 patients, respectively, who were treated for 6 weeks with bupropion. There was a curvilinear relationship between antidepressant efficacy and trough plasma bupropion concentrations, with maximum response observed at 5-100 ng/ml and virtually none below 25 ng/ml. The increase in plasma bupropion concentration from the trough level to the 4 hour postdose peak level was also positively related to antidepressant response.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000639:Amitriptyline / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000097:blood* / Q000627:therapeutic use; D016642:Bupropion; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000097:blood / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D010919:Placebos; D011427:Propiophenones / Q000097:blood* / Q000627:therapeutic use; D011569:Psychiatric Status Rating Scales
D000928:Antidepressive Agents; D010919:Placebos; D011427:Propiophenones; D016642:Bupropion; D000639:Amitriptyline