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Bupropion for GAD David N. Osser, MD Associate Professor of Psychiatry Harvard Medical School Brockton Division of the VA Boston Healthcare System General Editor - Psychopharmacology Algorithm Project Harvard South Shore Residency Training Program

Bupropion for GAD n=24 Bupropion 150-300 mg/day GAD (DSM-IV) CGI-I HAM-A: 5.3 GAD (DSM-IV) CGI-I HAM-A Escitalopram 10-20 mg/day n=24 HAM-A: 11.4 Bystritsky, A., Kerwin, L., Feusner, J. D., & Vapnik, T. (2008). A pilot controlled trial of bupropion XL versus escitalopram in generalized anxiety disorder. Psychopharmacology bulletin, 41(1), 46-51.

Bupropion for GAD MDD + Anxiety Sertraline Bupropion No differences in: Anxiolytic and antidepressant effects Activation and insomnia - Trivedi, M. H., Rush, A. J., Carmody, T. J., Donahue, R. M., Bolden-Watson, C., Houser, T. L., & Metz, A. (2001). Do bupropion SR and sertraline differ in their effects on anxiety in depressed patients?. The Journal of clinical psychiatry, 62(10), 776-781. - Zimmerman, M., Posternak, M. A., Attiullah, N., Friedman, M., Boland, R. J., Baymiller, S., ... & Chelminski, I. (2005). Why isn't bupropion the most frequently prescribed antidepressant?. The Journal of clinical psychiatry, 66(5), 603-610.

STAR*D Buspirone Augmentation for anxious patients Bupropion 9% remissions 18% remissions First-line over SSRIs for MDD? Trivedi, M. H., Rush, A. J., Carmody, T. J., Donahue, R. M., Bolden-Watson, C., Houser, T. L., & Metz, A. (2001). Do bupropion SR and sertraline differ in their effects on anxiety in depressed patients?. The Journal of clinical psychiatry, 62(10), 776-781. Fava, M., Rush, A. J., Alpert, J. E., Balasubramani, G. K., Wisniewski, S. R., Carmin, C. N., ... & Warden, D. (2008). Difference in treatment outcome in outpatients with anxious versus nonanxious depression: a STAR* D report. American Journal of Psychiatry, 165(3), 342-351.

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