Bupropion SR vs. placebo for weight loss in obese patients with depressive symptoms.
OBJECTIVE
This randomized, double-blind, placebo-controlled study evaluated the efficacy and tolerability of bupropion sustained-release (bupropion SR) in reducing weight and depressive symptoms in obese adults.


METHODS
Obese adults (body mass index, 30 to 44 kg/m(2)) not currently meeting criteria for major depression but with depressive symptoms (Beck Depression Inventory score 10-30) received bupropion SR 300 mg/d or placebo for 26 weeks with a 500 kcal/d-deficit diet. Patients who lost <5% of baseline weight at week 12 had bupropion SR dosage or placebo increased to 400 mg/d in a blinded fashion.


RESULTS
The bupropion SR group (n = 193) lost an average of 4.4 kg (4.6% of baseline weight) vs. 1.7 kg (1.8% of baseline weight) on placebo (n = 191, p < 0.001, last-observation-carried-forward analysis). More patients in the bupropion SR group than in the placebo group (40% vs. 16% of intent-to-treat sample, 50% vs. 28% of completers, respectively) lost at least 5% of baseline weight (p < 0.05 at week 4, p < 0.001 at weeks 6 to 26). The percentage of patients reporting > or =50% decrease in depressive symptoms did not differ between groups, but depressive symptoms improved more with bupropion SR than with placebo among patients with a history of major depression (p < 0.05, weeks 4 to 26). In the sample as a whole, improvement in depressive symptoms was related to weight loss of > or =5% regardless of treatment (p < 0.0001). Bupropion SR was well-tolerated.


CONCLUSIONS
Bupropion SR in combination with a 500 kcal/d-deficit diet facilitated weight loss. Weight loss of > or =5% may improve mood in obese patients with depressive symptoms.
Jain
Adesh K
AK
Medical Research Institute, Slidell, Louisiana, USA. ajain@medresearch.com
Kaplan
Roy A
RA
Gadde
Kishore M
KM
Wadden
Thomas A
TA
Allison
David B
DB
Brewer
Edwin R
ER
Leadbetter
Robert A
RA
Richard
Nathalie
N
Haight
Barbara
B
Jamerson
Brenda D
BD
Buaron
Kathleen S
KS
Metz
Alan
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D016642:Bupropion / Q000008:administration & dosage / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003692:Delayed-Action Preparations; D003863:Depression / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D004038:Diet, Reducing; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000523:psychology*; D014280:Triglycerides / Q000097:blood; D015431:Weight Loss / Q000187:drug effects*
D001786:Blood Glucose; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D014280:Triglycerides; D016642:Bupropion; D002784:Cholesterol