Bupropion for Major Depressive Disorder or Persistent Depressive Disorder (Dysthymia)


( Last Updated : April 26, 2021)
Project Line:
Health Technology Review
Project Sub Line:
Summary with Critical Appraisal
Project Number:
RC1352-000

Details


Question


  1. What is the clinical effectiveness of bupropion for the treatment of adults with major depressive disorder or persistent depressive disorder (dysthymia)?

  2. What is the costeffectiveness of bupropion for the treatment of adults with major depressive disorder or persistent depressive disorder (dysthymia)?


Key Message

Direct and indirect evidence from 6 systematic reviews did not demonstrate a difference in treatment response or remission rates, or functional outcomes, with bupropion as compared to other antidepressants in adults with major depressive disorder.Direct and indirect evidence from 5 systematic reviews did not demonstrate a difference in overall adverse events, overall withdrawals, or withdrawals due to adverse events apart from a possible decreased risk of withdrawal due to adverse events with vortioxetine in a single indirect comparison.Direct and indirect evidence from 2 systematic reviews supports that the risk of sexual dysfunction may be lower with bupropion than other antidepressants (escitalopram, paroxetine, sertraline, and fluoxetine), while 1 systematic review showed no significant difference in sexual function scores between bupropion and venlafaxine.There is limited evidence supporting the cost-effectiveness of bupropion to augment citalopram, and dominance of vortioxetine compared to bupropion, for major depressive disorder with inadequate response to initial therapy.There is a lack evidence surrounding the comparative clinical or cost-effectiveness of bupropion in dysthymia.