Depression Clinical Trial
Official title:
The Effects of Wellbutrin (Bupropion) on Residual and Cognitive Symptoms in SSRI-treated Depression
Many people with depression are treated with a serotonin-specific reuptake inhibitor anti-depressant (SSRI) and feel 'better'. Although many people feel 'better', they do not feel completely 'well'. Often, individuals continue to complain of cognitive problems such as lack of attention, diminished motivation, and impaired problem-solving. This study looks at whether residual and cognitive symptoms of depression in individuals are affected by the addition of Wellbutrin (bupropion).
As many as 65-75% of treated patients continue to experience residual symptoms of
depression. Cognitive impairments feature frontal cognitive dysfunction. Many experts
believe that executive functions are better predictors of functional level than psychiatric
diagnoses.
Frontal cognitive impairment and changes in neuroimaging are seen in individuals depleted of
tryptophan, a serotonin precursor. These cognitive changes do not improve following
serotonin-specific reuptake inhibitor treatment and at least one study has found that
executive dysfunction predicts non-response to fluoxetine. In many patients, remission of
mood symptoms in depression requires medications to target non-serotonergic neurotransmitter
systems. Brain areas mediating executive functions receive rich noradrenergic inputs, and
norepinephrine is known to be intimately involved in many of the executive functions.
A better understanding of serotonergic and catecholaminergic interactions would enable
evidence-based treatment of depression which maximizes executive cognitive functions. This
study examines the hypothesis that individuals treated with Wellbutrin will have higher
scores on tests of executive functions and lower scores on depression indices.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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