Bupropion HCL and Sleep in Patients with Depression

Author(s): Andrew D. Krystal , Michael E. Thase , Vivian L. Tucker , Elizabeth P. Goodale .

Journal Name: Current Psychiatry Reviews

Volume 3 , Issue 2 , 2007

Abstract:

Objectives: Depressed patients often have insomnia, daytime sleepiness, and/or changes in sleep architecture. These sleep/wake changes are associated with diminished quality of life, impaired function, diminished treatment response and greater risk of relapse. Antidepressants may cause, exacerbate, or ameliorate these sleep/wake alterations. The sleep/wake effects of bupropion, a norepinephrine/ dopamine reuptake inhibitor (NDRI), are relatively less well established. We carried out this literature review in order to characterize the sleep/wake effects of bupropion, provide an understanding of the antidepressant mechanisms involved and discuss implications for clinical practice. Methods: Manuscripts were identified using PubMed. In addition, reports were selected from references in the original search and reports concerning bupropion extended-release were provided by the manufacturer. Results: Bupropion was not associated with daytime sedation. Sleep disturbance occurs at a low rate, comparable to other modern reuptake inhibitors. Unlike other antidepressants, bupropion does not suppress REM sleep nor increase the risk of periodic leg movement disorder. Conclusion: Bupropion has a unique sleep/wake profile, which may be particularly well-suited for treatment of individuals suffering from depression accompanied by significant fatigue/sleepiness. A lack of REM suppression, which likely reflects bupropions NDRI mechanism of action, is also distinctive and does not affect antidepressant efficacy.

Keywords: Antidepressants, sleep electroencephalogram, REM sleep, insomnia, sedation, periodic leg movements

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Article Details

VOLUME: 3
ISSUE: 2
Year: 2007
Page: [123 - 128]
Pages: 6
DOI: 10.2174/157340007780599096
Price: $58

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