The Effects of Wellbutrin (Bupropion) on Residual and Cognitive Symptoms in SSRI-treated Depression
The Effects of Wellbutrin (Bupropion) on Residual and Cognitive Symptoms in SSRI-treated Depression
Many people with depression are treated with a serotonin-specific reuptake inhibitor
 anti-depressant (SSRI) and feel 'better'. Although many people feel 'better', they do not
 feel completely 'well'. Often, individuals continue to complain of cognitive problems such as
 lack of attention, diminished motivation, and impaired problem-solving. This study looks at
 whether residual and cognitive symptoms of depression in individuals are affected by the
 addition of Wellbutrin (bupropion).
As many as 65-75% of treated patients continue to experience residual symptoms of depression.
 Cognitive impairments feature frontal cognitive dysfunction. Many experts believe that
 executive functions are better predictors of functional level than psychiatric diagnoses.

 Frontal cognitive impairment and changes in neuroimaging are seen in individuals depleted of
 tryptophan, a serotonin precursor. These cognitive changes do not improve following
 serotonin-specific reuptake inhibitor treatment and at least one study has found that
 executive dysfunction predicts non-response to fluoxetine. In many patients, remission of
 mood symptoms in depression requires medications to target non-serotonergic neurotransmitter
 systems. Brain areas mediating executive functions receive rich noradrenergic inputs, and
 norepinephrine is known to be intimately involved in many of the executive functions.

 A better understanding of serotonergic and catecholaminergic interactions would enable
 evidence-based treatment of depression which maximizes executive cognitive functions. This
 study examines the hypothesis that individuals treated with Wellbutrin will have higher
 scores on tests of executive functions and lower scores on depression indices.
Inclusion Criteria:

 -  Depression

 -  SSRI-treated

 Exclusion Criteria:

 -  Bipolar disorder

 -  Serotonin-norepinephrine reuptake inhibitor (SNRI) or bupropion treatment

 -  Treatment-resistant depression

 -  Seizure disorder

 -  Bulimia or anorexia nervosa

 -  Pregnancy