A placebo-controlled trial of bupropion SR in the treatment of chronic posttraumatic stress disorder.
OBJECTIVE
Although selective serotonin reuptake inhibitors have been the most empirically studied pharmacotherapy for posttraumatic stress disorder (PTSD), a need remains for the investigation of additional pharmacological agents in the treatment of PTSD. The present study examined the use of bupropion sustained release (SR) as compared with placebo for symptom reduction in patients with PTSD: approximately half who were already prescribed an selective serotonin reuptake inhibitor and half who were not.


METHODS
Thirty patients (mean age, 50 years) with civilian- or military-related PTSD enrolled in an 8-week evaluation of bupropion SR versus placebo assigned in a 2:1 ratio in addition to their usual pharmacological care. Statistical tests included analyzing both study completers and using an intent-to-treat analysis, as well as post hoc examination of responders versus nonresponders.


RESULTS
Although no between-group differences were detected, both groups reported a reduction in PTSD symptoms. In a hypothesis-generating post hoc analysis of responders versus nonresponders in the bupropion SR condition (defined as a Clinician Global Improvement score of at least minimally improved), it seemed that younger patients not currently on another antidepressant were more likely to benefit from bupropion.


CONCLUSIONS
Bupropion SR in the treatment of PTSD had no significant effect in the current sample. Factors contributing to the absence of an effect need further study. Our analysis points to the inclusion of age and concomitant antidepressant treatment as important variables in any future larger-scale study.
Becker
Mary E
ME
Durham VA Medical Center, NC 27705, USA.
Hertzberg
Michael A
MA
Moore
Scott D
SD
Dennis
Michelle F
MF
Bukenya
Deo S
DS
Beckham
Jean C
JC
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001288:Attention / Q000187:drug effects; D016642:Bupropion / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use; D003692:Delayed-Action Preparations / Q000009:adverse effects / Q000627:therapeutic use*; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D007172:Erectile Dysfunction / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy*; D013610:Tachycardia / Q000139:chemically induced; D013997:Time Factors; D014196:Trazodone / Q000009:adverse effects / Q000627:therapeutic use
D018687:Antidepressive Agents, Second-Generation; D014150:Antipsychotic Agents; D016642:Bupropion; D015283:Citalopram; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D012702:Serotonin Antagonists; D017367:Selective Serotonin Reuptake Inhibitors; D014196:Trazodone