Original articlesBupropion and venlafaxine responders differ in pretreatment regional cerebral metabolism in unipolar depression
Section snippets
Subjects
Through local newspaper advertisements in the Washington, D.C., metropolitan area, the study recruited 23 outpatients with unipolar depression (11 women, 12 men; mean age 46.3 ± 12.9 SD) and no history of psychiatric hospitalization and 20 healthy control subjects (11 women, 9 men; mean age 46.6 ± 13.1 SD) without personal or first-degree relative history of psychiatric illness. After a complete description and discussion of the study including the possible risks and benefits of participation,
Clinical data
Of 23 patients, 17 were crossed over to the other drug (phase 2) because of suboptimal treatment response or side effects on the first treatment phase (phase 1). Based on CGI determinations, overall treatment responses (defined as moderate to marked improvement) were similar for buproprion (32%) and venlafaxine (33%). With bupropion 25% of patients responded in phase 1, and 43% of patients responded in phase 2. With venlafaxine 36% of patients responded in phase 1 and 30% of patients responded
Discussion
Among 20 never-hospitalized outpatients with unipolar depression compared with control subjects, responders but not nonresponders to monotherapy with either bupropion or venlafaxine showed baseline bilateral frontal and left temporal hypometabolism. Selectively, only bupropion responders also showed cerebellar hypermetabolism, whereas only venlafaxine responders additionally showed right temporal and basal ganglia hypometabolism. To our knowledge, this is the first functional brain imaging
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