Bupropion in the treatment of outpatients with asthma and major depressive disorder

Objective: Depressive disorders are common in asthma. Despite the high prevalence, antidepressant therapy in asthma patients with depression remains under-investigated. The objective of this pilot study was to investigate the use of bupropion for depression and anxiety in depressed asthma patients. Method: We conducted a 12-week open-label study of bupropion in 18 depressed asthma patients. Participants were assessed with the Hamilton Rating Scale for Depression (HAM-D-17), Hamilton Rating Scale for Anxiety (HAM-A), Inventory of Depressive Symptomatology - Self-Report (IDS-SR), Asthma Control Questionnaire (ACQ) and spirometry at baseline and weeks 1, 2, 4, 8, and 12. Results: Significant baseline to exit improvements were observed on the HAM-D-17 (mean change = 4.72, SD = 7.78, p = 0.02) and the HAM-A (mean change = 2.12, SD = 3.97, p = 0.04). Based on the HAM-D-17 scores, 27.8% of the patients were responders and 16.7% were remitters. Significant correlations were found between changes in ACQ score and HAM-D-17 r = 0.73, p = 0.001), ACQ score and IDS-SR r = 0.58, p = 0.012), and FEV₁% Predicted and HAM-D-17 r = -0.66, p = 0.006). Conclusions: Bupropion treatment was associated with significant improvements in depression and anxiety symptoms in asthma patients. Improvements in asthma correlated significantly with improvements in depression.