title: Comparison of the Efficacy and Safety of Aripiprazole Versus Bupropion Augmentation in Patients With Major Depressive Disorder Unresponsive to Selective Serotonin Reuptake Inhibitors: A Randomized, Prospective, Open-Label Study.
abstract: OBJECTIVE
  The purpose of this study was to compare the efficacy and safety of aripiprazole versus bupropion augmentation in patients with major depressive disorder (MDD) unresponsive to selective serotonin reuptake inhibitors (SSRIs).
  
  
  METHODS
  This is the first randomized, prospective, open-label, direct comparison study between aripiprazole and bupropion augmentation. Participants had at least moderately severe depressive symptoms after 4 weeks or more of SSRI treatment. A total of 103 patients were randomized to either aripiprazole (n = 56) or bupropion (n = 47) augmentation for 6 weeks. Concomitant use of psychotropic agents was prohibited. Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale, Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores were obtained at baseline and after 1, 2, 4, and 6 weeks of treatment.
  
  
  RESULTS
  Overall, both treatments significantly improved depressive symptoms without causing serious adverse events. There were no significant differences in the Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale, and Iowa Fatigue Scale scores, and response rates. However, significant differences in remission rates between the 2 groups were evident at week 6 (55.4% vs 34.0%, respectively; P = 0.031), favoring aripiprazole over bupropion. There were no significant differences in adverse sexual events, extrapyramidal symptoms, or akathisia between the 2 groups.
  
  
  CONCLUSIONS
  The present study suggests that aripiprazole augmentation is at least comparable to bupropion augmentation in combination with SSRI in terms of efficacy and tolerability in patients with MDD. Both aripiprazole and bupropion could help reduce sexual dysfunction and fatigue in patients with MDD. Aripiprazole and bupropion may offer effective and safe augmentation strategies in patients with MDD who are unresponsive to SSRIs. Double-blinded trials are warranted to confirm the present findings.
authors.affiliation: From the *Department of Psychiatry, Yeungnam University College of Medicine, Yeungnam University Medical Center, Daegu; †Department of Neuropsychiatry, Dongguk University Kyungju Hospital, Kyungju; ‡Department of Neuropsychiatry, Daegu Fatima Hospital; §Department of Psychiatry, Catholic University of Daegu School of Medicine; ∥Department of Psychiatry, Kyungpook National University School of Medicine, Daegu; and ¶Department of Neuropsychiatry, College of Medicine, Pochon Cha University, Cha Hospital, Gumi, Republic of Korea.
authors.forename: Eun-Jin
authors.initials: EJ
authors.lastname: Cheon
authors.forename: Kwang-Hun
authors.initials: KH
authors.lastname: Lee
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Park
authors.forename: Jong-Hun
authors.initials: JH
authors.lastname: Lee
authors.forename: Bon-Hoon
authors.initials: BH
authors.lastname: Koo
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Lee
authors.forename: Hyung-Mo
authors.initials: HM
authors.lastname: Sung
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D000068180:Aripiprazole / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D016642:Bupropion / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D003865:Major Depressive Disorder / Q000188:drug therapy*; D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy*; D018765:Dopamine Uptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004357:Drug Synergism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*
chemical_list: D014150:Antipsychotic Agents; D000068180:Aripiprazole; D016642:Bupropion; D018765:Dopamine Uptake Inhibitors; D017367:Selective Serotonin Reuptake Inhibitors