Does pretreatment insomnia or anxiety predict acute response to bupropion SR?

This retrospective analysis was conducted to determine whether pretreatment levels of insomnia or anxiety were associated with likelihood of or time to antidepressant response with bupropion sustained release (SR).

Data from an open-label, 8-week, acute phase multicenter study of 797 adult outpatients with recurrent, nonpsychotic major depressive disorder who received bupropion SR (300 mg/day) were used. Depressive symptom severity was measured by the 17-item Hamilton Rating Scale for Depression (HAM-D17), insomnia by totaling the three HAM-D17 insomnia items (early, middle, late), and anxiety by the 14-item Hamilton Rating Scale forAnxiety.

Overall, 67% (533/797) of patients responded (defined as > or = 50% reduction in baseline HAM-D17). Neither baseline insomnia nor baseline anxiety was related to the likelihood of achieving response. Higher baseline insomnia and lower baseline anxiety were associated with an earlier onset of response (about one week sooner in each).

Predicting the likelihood of antidepressant response with bupropion SR cannot be based on either baseline insomnia or anxiety levels.