Key result
Bupropion demonstrated a wider cardiovascular safety margin than nortriptyline, which caused significant heart rate increases (14.5-18 bpm) and symptomatic orthostatic hypotension.
Why the study?
Does bupropion have a better cardiovascular safety profile compared to nortriptyline in adult outpatients with major depression?
Population
115 adult outpatients with major depression
Comparison
Bupropion 225-450 mg/day for 6 weeks vs Nortriptyline 75-150 mg/day for 6 weeks
Design
RCT, Randomized after a 1-week placebo phase, Double-blind
Follow-up
6 weeks
Authors
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Nortriptyline warrants heart rate monitoring in depressed patients; extends RCT evidence of differential cardiovascular effects versus bupropion.
RCT (n=115)
Double-blind
randomized
Does bupropion have a better cardiovascular safety profile compared to nortriptyline in adult outpatients with major depression?
Bupropion demonstrates a wider cardiovascular safety margin compared to nortriptyline in depressed outpatients, avoiding the significant heart rate increases, symptomatic orthostatic hypotension, and conduction slowing seen with nortriptyline.
Kiev et al. (1994) conducted an RCT in Major depression (n=115). Bupropion vs. Nortriptyline (75-150 mg/day) was evaluated on Cardiovascular effects (heart rate, blood pressure, orthostatic changes, cardiac conduction). Bupropion demonstrated a wider cardiovascular safety margin than nortriptyline, which caused significant heart rate increases (14.5-18 bpm) and symptomatic orthostatic hypotension.
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