Bupropion Sustained Release for Bereavement: Results of an Open Trial

Sidney Zisook, M.D.; Stephen R. Shuchter, M.D.; Paola Pedrelli, B.A.; Jeremy Sable, M.D.; and Simona C. Deaciuc, M.D.

Objective: The present study was conducted to assess whether DSM-IV-defined bereavement responds to bupropion sustained release (SR).

Method: Twenty-two subjects who had lost their spouses within the previous 6 to 8 weeks and who met DSM-IV symptomatic/functional criteria for a major depressive episode were evaluated. Subjects completed the Hamilton Rating Scale for Depression (HAM-D), the Clinical Global Impressions scale, the Texas Revised Inventory of Grief, and the Inventory of Complicated Grief at baseline and follow-up. Subjects were treated with bupropion SR, 150 to 300 mg/day, for 8 weeks.

Results: Improvement was noted in both depression and grief intensity. For the intent-to-treat group, 59% experienced a reduction of >= 50% on HAM-D scores. The correlations between changes in the HAM-D scores and the grief scale scores were high, ranging from 0.61 (p = .006) to 0.44 (p = .054).

Conclusion: Major depressive symptoms occurring shortly after the loss of a loved one (i.e., bereavement) appear to respond to bupropion SR. Treatment of these symptoms does not intensify grief; rather, improvement in depression is associated with decreases in grief intensity. The results of this study challenge prevailing clinical wisdom that DSM-IV-defined bereavement should not be treated. Larger, placebo-controlled studies are indicated.

(J Clin Psychiatry 2001;62:227-230)

Received May 23, 2000; accepted Oct. 4, 2000. From the Department of Psychiatry, University of California San Diego (all authors); and San Diego Veterans Healthcare System, San Diego (Dr. Zisook and Ms. Pedrelli), Calif.

Sponsored by GlaxoWellcome, Research Triangle Park, N.C.

Supported by MHCRC grant # 2-3PO-MH30914-22 from the National Institute of Mental Health, Rockville, Md. (Dilip V. Jeste, M.D.).

Presented as a poster at the 152nd annual meeting of the American Psychiatric Association, May 15-20, 1999, Washington, D.C.

Financial disclosure: Dr. Zisook is a consultant for Glaxo Wellcome, SmithKline Beecham Pharmaceuticals, Pfizer Inc, and Novartis Pharmaceuticals Corporation; has received grant/research support from Bristol-Myers Squibb Company; has received honoraria from Wyeth-Ayerst Laboratories, Eli Lilly and Company, and Forest Pharmaceuticals, Inc.; and is on the speakers bureau for Glaxo Wellcome and SmithKline Beecham Pharmaceuticals.

Reprint requests to: Sidney Zisook, M.D., Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 (e-mail: szisook@ucsd.edu).