Does Sleep Quality Change After Switch From Wellbutrin SR to Wellbutrin XL in Patients With Major Depressive Disorder?

Sponsor
Queen's University (Other)
Overall Status
Completed
CT.gov ID
NCT00616915
Collaborator
(none)
20
1
1
36
0.6

Study Details

Study Description

Brief Summary

Wellbutrin (bupropion) is an effective antidepressant (Thase, M 2005). It exists in instant release (IR), sustained release (SR) and extended release (XL) forms. The IR formulation was never approved for use in Canada. The XL formulation allows for once daily dosing.

Wellbutrin is both a norepinephrine and dopamine reuptake inhibitor, and as such increases the synaptic concentration of both neurotransmitters. This adds to its positive effects on cognition, apathy, tiredness and executive functioning. The increased activation may be also responsible for some of its side effects such as initial insomnia and reduced sleep efficiency, especially when taken at night.

Condition or Disease Intervention/Treatment Phase
  • Drug: Wellbutrin XL
Phase 1

Detailed Description

Wellbutrin SR formulation cannot be given as more than 150 mg as a single dose and higher doses are commonly required for the treatment of depression; they also have to be given at least 8 hours apart in order to avoid peak plasma concentrations and to reduce the risk of seizures (incidence of 0.1% at doses £ 300 mg). The twice a day dosing may result in complaints of insomnia and may necessitate discontinuing the medication or adding a sleep promoting agent. The benefit of once-daily dosing cannot be understated given treatment adherence is typically lower in depressed patients than their non-depressed counterparts; further, the 8 h dosing interval of bupropion SR is likely to have lower adherence compared with traditional bid dosing (i.e., morning and evening); thus, it is not difficult to imagine patients missing 30-50% of their second dose given the difficulty of recalling to take the second dose at work or school. The review of Fava et al. (2005) plots the relative PK profiles of XL and SR and notes the significantly lower bupropion concentration at bedtime, which is likely to reduce the occurrence of insomnia. Therefore, Wellbutrin XL may improve adherence by eliminating the second dose and Wellbutrin XL also avoids the high plasma drug concentrations at bedtime, as seen with bupropion SR, which are associated with insomnia. Further, the smoother pharmacokinetic profile of Wellbutrin XL may improve overall tolerability compared with Wellbutrin SR.

Study Design

Study Type:
Interventional
Actual Enrollment :
20 participants
Allocation:
Non-Randomized
Intervention Model:
Single Group Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
Does Sleep Quality Change After Switch From Wellbutrin SR to Wellbutrin XL in Patients With Major Depressive Disorder?
Study Start Date :
Jan 1, 2007
Actual Primary Completion Date :
Jan 1, 2009
Actual Study Completion Date :
Jan 1, 2010

Arms and Interventions

Arm Intervention/Treatment
Other: 1

Wellbutrin SR switched to Wellbutrin XL

Drug: Wellbutrin XL
Wellbutrin XL 300mg daily
Other Names:
  • Bupropion
  • Outcome Measures

    Primary Outcome Measures

    1. This study is looking at the effect of Wellbutrin SR versus Wellbutrin XL on sleep quality [pre, 3-5days, 3-4weeks after wellbutrinXL]

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 65 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    1. Signed Patient Informed Consent;

    2. Patients with Major Depressive Disorders (DSM-IV-TR - criteria used);

    3. Out-patients;

    4. Males or females over 18 years of age;

    5. Patients currently using Wellbutrin SR.

    Exclusion Criteria:
    1. Bipolar Disorder patients;

    2. Actively suicidal patients;

    3. Schizophrenia, Schizoaffective or other Psychotic Disorder;

    4. Pregnant women, as by pregnancy test at the beginning of the study;

    5. Women in childbearing age, refusing to use appropriate contraception, or breastfeeding mothers;

    6. Patients with known hypersensitivity to bupropion;

    7. Patients with severe or unstable medical conditions, which in the opinion of the investigator would interfere with their progress or safety;

    8. ECT or TMS treatments within the last three months;

    9. Patients who did not respond to previous treatment with bupropion;

    10. Patients with history of seizure disorder;

    11. Patients with history of eating disorders (e.g. bulimia, anorexia nervosa);

    12. Patients using sleep aiding medication (Benzodiazepines, barbiturates).

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Providence Care Mental Health Services Kingston Ontario Canada L7L 4X3

    Sponsors and Collaborators

    • Queen's University

    Investigators

    • Principal Investigator: Roumen V. Milev, MD, Queen's University

    Study Documents (Full-Text)

    None provided.

    More Information

    Publications

    None provided.
    Responsible Party:
    Dr. Roumen Milev, MD, Queen's University
    ClinicalTrials.gov Identifier:
    NCT00616915
    Other Study ID Numbers:
    • PSIY-219-05
    First Posted:
    Feb 15, 2008
    Last Update Posted:
    Dec 16, 2015
    Last Verified:
    Dec 1, 2015
    Keywords provided by Dr. Roumen Milev, MD, Queen's University
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Dec 16, 2015