title: Fatigue as a core symptom in major depressive disorder: overview and the role of bupropion.
abstract: Fatigue is one of the most common symptoms found in both community and medical care settings. Fatigue may imply a prodromal or residual symptom of major depressive disorder or an adverse reaction to antidepressant treatment. Fatigue may also compromise antidepressant treatment by delaying response to antidepressants. Despite the importance of fatigue as a core depressive symptom, data specific to the effects of fatigue on pharmacological treatment are still lacking. Bupropion is an atypical antidepressant, chemically unrelated to classical agents such as tricyclic antidepressants, selective serotonin reuptake inhibitors and other contemporary antidepressants. With a pharmacological profile that involves neurotransmitter reuptake inhibition, bupropion shares a broad range of biological properties with psychostimulants. The primary action mode of bupropion involves dopaminergic and noradrenergic neurotransmissions rather than serotonergic mechanisms, although its exact pharmacodynamic properties remain uncertain. Hence, it is possible that bupropion may play a role in the treatment of fatigue-related symptoms of major depressive disorder. This paper presents a brief overview of the clinical implications and neurobiology of major depressive disorder-related fatigue, as well as the pharmacological profile of bupropion and currently available clinical data related to its treatment of fatigue-related symptoms of major depressive disorder.
authors.affiliation: Department of Psychiatry, Kangnam St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul 137-701, South Korea. pae@catholic.ac.kr
authors.forename: Chi-Un
authors.initials: CU
authors.lastname: Pae
authors.forename: Hyun-Kook
authors.initials: HK
authors.lastname: Lim
authors.forename: Changsu
authors.initials: C
authors.lastname: Han
authors.forename: Ashwin A
authors.initials: AA
authors.lastname: Patkar
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.forename: Prakash S
authors.initials: PS
authors.lastname: Masand
authors.forename: Chul
authors.initials: C
authors.lastname: Lee
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D016642:Bupropion / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005221:Fatigue / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans
chemical_list: D018687:Antidepressive Agents, Second-Generation; D016642:Bupropion