Depression Clinical Trial
Official title:
SSRI Versus Bupropion in High-Risk Major Depressive Disorder
This study uses functional magnetic resonance imaging (fMRI) to investigate the effects of two different antidepressant medications (Paxil CR versus Wellbutrin XL) on reward processing in depressed patients who have attempted suicide or are currently experiencing suicidal thoughts.
Major depressive disorder (MDD) is a common and serious psychiatric illness. It is among the
leading causes of disability and is the psychiatric disorder most often associated with
suicide. The treatment of MDD with antidepressant medication remains largely trial and error.
Little empirical evidence exists to guide the treatment of MDD when suicide risk is a major
factor.
The study uses functional magnetic resonance imaging (fMRI) to compare the effects of
paroxetine, an SSRI, versus bupropion, a non-SSRI, on brain activity in depressed patients
with a past suicide attempt and/or current suicidal thoughts. Participants are randomly
assigned to either paroxetine or bupropion treatment for 8 weeks, with fMRI scans involving a
reward processing task at baseline and Week 8. Weekly study visits include interviews with a
psychologist, self-report scales, and medication monitoring. All participants will then be
offered 4 additional months of open clinical treatment. If original medication assignments
prove to be ineffective, participants will have the option to switch to another medication.
After completing the study, participants will be referred for ongoing treatment.
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