7.2.1.2
Study Plan
7.2.1.2.1
Objectives/Rationale
The
objective of this trial was to compare the safety and efficacy of two doses of
bupropion sustained-release and placebo in the treatment of patients with major
depression.
7.2.1.2.2
Population
·
The
following summarizes inclusion criteria for the study:
·
Age
greater than 17 years old
·
Good
physical health
·
Meeting
DSM-III-R criteria for Major Depressive Disorder, with a current Major Depressive
Episode of between four weeks and two years duration
·
Score
of at least 20 on the first 17 items of the 28-item Hamilton Depression Scale
(HAMD) at both time of screening and after one week of placebo washout, with a
drop of not more than 20 per cent over the week of placebo washout.
Patients
were excluded for the following:
·
Predisposition
to seizures, either by personal or family history, or by concurrent brain tumor
or seizure-threshold-lowering medications
·
Presence
of a significant DSM-III-R Axis diagnosis that would suggest non-responsiveness
to pharmacotherapy for depression
·
History
of diagnosis of anorexia or bulimia
·
Presence
of medical disorder that would interfere with drug levels or with the accurate
assessment of depression
·
Females
who were pregnant, breast-feeding, or unwilling to employ appropriate
contraceptive methods during the study.
·
History
within one year of alcohol or substance abuse
·
Receipt
of fluoxetine or an investigational drug within four weeks of the treatment
phase, receipt of an MAOI drug or protiptyline within two weeks of the
treatment phase, or receipt of any other psychoactive drug within one week of
the treatment phase.
·
History
of treatment with bupropion
·
Incapable
of spontaneous conversation or activity
·
Active
suicidality.
7.2.1.2.3
Planned Study Conduct/Dosing
Plan
Following
one week of single-blind b.i.d. placebo washout, this trial was an eight week,
parallel, double blind study; patients were randomly assigned to receive placebo,
or one of two dose levels of bupropion sustained-release. Patients were randomized in blocks of six,
with equal chances of receiving any of the three treatments. Medication consisted of
identically-appearing tablets containing either placebo or 150 mg bupropion
sustained-release. Each patient
received a blister card containing a ten day supply of medication each
week. They were instructed to take one
tablet in the morning and one each evening and to return the blister card with
all unused tablets. On this schedule, patients either received placebo b.i.d.,
150 mg bupropion sustained-release qam and placebo qpm, or 150 mg bupropion
sustained-release b.i.d. To adjust to
the dosage, patients in the latter group received placebo in the evening for the
first three days of the study. Patients
who experienced intolerable adverse effects from their assigned dose were to be
discontinued from the trial. Except for
chloral hydrate that was permitted as a supplement in the first two weeks of
the study, concomitant psychoactive medications were not permissible. Compliance was assessed by weekly review of
the blister card.
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