Effect on body weight of bupropion sustained-release in patients with major depression treated for 52 weeks

Background: Short-term studies have demonstrated a modest weight-reducing to weight-neutral effect among patients receiving bupropion sustained-release (SR) for the treatment of depression. Objective: This study was conducted to evaluate the long-term effects of bupropion SR on body weight in patients with depression. Methods: This analysis was conducted within a long-term relapse-prevention study in patients with major depression. Those whose depression had responded to open-label treatment with bupropion SR were randomized to 44 weeks of double-blind treatment with bupropion SR 300 mg/d or placebo. Patients were categorized by body mass index (BMI) as follows: BMI <22, BMI 22 to 26, BMI ≥27, and BMI ≥30. Results: Four hundred twenty-three patients were enrolled in the double-blind phase of the study, 210 receiving bupropion SR and 213 receiving placebo. At the end of the open-label phase, the following mean weight losses were seen in the 4 BMI groups: BMI <22, 0.5 kg; BMI 22 to 26, 1.1 kg; and BMI ≥27 and BMI ≥30, 1.8 kg each. At the end of double-blind treatment, mean change-from-baseline weights were as follows: BMI <22, −0.1 kg; BMI 22 to 26, −0.6 kg; BMI ≥27, −1.4 kg; and BMI ≥30, −2.4 kg. The rate of change in body weight during the double-blind phase was statistically significant compared with baseline BMI (P < 0.001, analysis of covariance). Conclusions: Modest mean weight losses that increased with increasing baseline body weight were observed with long-term bupropion SR treatment. The findings of this analysis suggest that bupropion SR may be an appropriate therapeutic option in normal-weight or overweight patients with depression who are concerned about weight gain.