Bupropion SR vs. Placebo for Weight Loss in Obese Patients with Depressive Symptoms |
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Authors: | Adesh K Jain MD Roy A Kaplan Kishore M Gadde Thomas A Wadden David B Allison Edwin R Brewer Robert A Leadbetter Nathalie Richard Barbara Haight Brenda D Jamerson Kathleen S Buaron Alan Metz |
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Institution: | 1. East Bay Clinical Trial Center, Concord, California;2. Duke University Medical Center, Durham, North Carolina;3. University of Pennsylvania, Philadelphia, Pennsylvania;4. University of Alabama at Birmingham, Birmingham, Alabama;5. GlaxoSmithKline, Research Triangle Park, North Carolina |
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Abstract: | Objective: This randomized, double-blind, placebocontrolled study evaluated the efficacy and tolerability of bupropion sustained-release (bupropion SR) in reducing weight and depressive symptoms in obese adults. Research Methods and Procedures: Obese adults (body mass index, 30 to 44 kg/m2) not currently meeting criteria for major depression but with depressive symptoms (Beck Depression Inventory score 10–30) received bupropion SR 300 mg/d or placebo for 26 weeks with a 500 kcal/d-deficit diet. Patients who lost <5% of baseline weight at week 12 had bupropion SR dosage or placebo increased to 400 mg/d in a blinded fashion. Results: The bupropion SR group (n = 193) lost an average of 4.4 kg (4.6% of baseline weight) vs. 1.7 kg (1.8% of baseline weight) on placebo (n = 191, p < 0.001, last-observation-carried-forward analysis). More patients in the bupropion SR group than in the placebo group (40% vs. 16% of intent-to-treat sample, 50% vs. 28% of completers, respectively) lost at least 5% of baseline weight (p < 0.05 at week 4, p < 0.001 at weeks 6 to 26). The percentage of patients reporting ≥50% decrease in depressive symptoms did not differ between groups, but depressive symptoms improved more with bupropion SR than with placebo among patients with a history of major depression (p < 0.05, weeks 4 to 26). In the sample as a whole, improvement in depressive symptoms was related to weight loss of ≥5% regardless of treatment (p < 0.0001). Bupropion SR was well-tolerated. Discussion: Bupropion SR in combination with a 500 kcal/d-deficit diet facilitated weight loss. Weight loss of ≥5% may improve mood in obese patients with depressive symptoms. |
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Keywords: | bupropion sustained-release antidepressant anorexigens depression clinical trial |
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