Do Bupropion SR and Sertraline Differ in Their Effects on Anxiety in Depressed Patients?
J Clin Psychiatry 2001;62(10):776-781
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: To examine the effects of bupropion
sustained release (SR) and sertraline on anxiety in outpatients
with recurrent DSM-IV-defined major depressive disorder.
Method: This retrospective analysis was
conducted using pooled data from 2 identical, 8-week,
acute-phase, double-blind, placebo-controlled, parallel-group
studies of bupropion SR (N = 234), sertraline (N = 225), and
placebo (N = 233). Symptoms of anxiety and depression were
measured using the 14-item Hamilton Rating Scale for Anxiety
(HAM-A) and the 21-item Hamilton Rating Scale for Depression
(HAM-D-21), respectively. Percentage reduction in baseline HAM-A
total score for each treatment week was calculated to determine
whether the time to onset of anxiolytic activity differed among
antidepressant responders to each agent. Central nervous system
(CNS) adverse events were tabulated.
Results: Bupropion SR and sertraline were
comparably effective, both were superior to placebo in reducing
depressive symptoms, and they did not differ in their effect on
anxiety symptoms. Antidepressant responders ( 50% reduction in
baseline HAM-D-21 score) in both groups showed marked and
comparable reductions in HAM-A scores (baseline to exit). There
were no differences between bupropion SR and sertraline in the
median time (4 weeks) to reach a clinically significant
anxiolytic effect ( 50% reduction in baseline HAM-A score). CNS
adverse events were comparable for bupropion SR and sertraline,
except for somnolence, which was more common in
Conclusion: Bupropion SR and sertraline had
comparable antidepressant and anxiolytic effects and an equally
rapid onset of clinically significant anxiolytic activity. There
was no difference in the activating effects between the 2
antidepressants. Selection between these 2 agents cannot be based
on either anticipation of differential anxiolytic activity or
differential CNS side effect profiles.