COMPARISON OF BUPROPION AND TRAZODONE FOR THE TREATMENT OF MAJOR DEPRESSION

Bupropion and trazodone were compared in a two-center, double-blind cl inical trial of outpatients with moderate to severe major depression. After a 1-week placebo lead-in, 124 patients were randomly assigned to receive either bupropion (N = 63) or trazodone (N = 61) for 6 weeks; data from 111 patients were used in the efficacy analysis. Dosing rang ed from 225 to 450 mg/day for bupropion and 150 to 400 mg/day for traz odone. The overall efficacy for each of the two drugs was similar; alt hough improvement in the trazodone treatment group was significantly g reater on day 7 because of the effects on sleep. At the end of treatme nt, 58% of the bupropion-treated patients and 46% of the trazodone-tre ated patients were considered much or very much improved. Weight measu rements at the time of discontinuation indicated a 2.5-lb mean weight loss for the bupropion treatment group and a 1.2-lb mean weight gain f or the trazodone treatment group. The adverse experience profiles for bupropion and trazodone were consistent with their known pharmacologic profiles (i.e., activating versus sedating). Anorexia and anxiety wer e reported significantly more often for the bupropion treatment group, whereas somnolence, appetite increase, and edema were reported signif icantly more often for the trazodone treatment group.