Memory Functioning and Antidepressant Treatment

Purpose of the Present Study:

The purpose of the present study is to comprehensively evaluate memory functioning of MDD patients before and after 8 weeks of antidepressant treatment with bupropion-XL or escitalopram. A neuropsychological test battery will incorporate multiple aspects of memory functioning including: short-term & working memory; verbal, non-verbal, spatial and prospective memory.

Major Research Questions:

• Which subtypes of memory at baseline are more impaired?
• What is the relationship between memory impairment and symptom severity and previous number of episodes or duration of illness?
• Is successful AD treatment associated with improvement in memory functioning?
• Is there a main effect by AD type?
• On which subtypes of memory do patients improve, worsen, or remain neutral in the 2 different AD groups? (Main effect of memory type?)
• What is the relationship between change in memory function and symptomatic outcome?

Study Design:

This is a randomized, double-blind, double-dummy trial comparing the memory functioning of depressed subjects before and after 8 weeks of treatment with bupropion-XL as compared to escitalopram.

All consenting, eligible subjects will receive either active bupropion-XL or active escitalopram following the baseline visit. Doses will be fixed with an opportunity for dose reduction if subjects are unable to tolerate fixed dose.

Inclusion criteria

• Males and Females
• Age: 18-50
• Recurrent Major Depressive Disorder; current Major Depressive Episode with at least one prior episode
• HAM-D >16
• Able to give written informed consent
• Agree to use a reliable means of birth control during the study, as determined by the investigator (females of child-bearing potential only)

Exclusion criteria

• History of head injury or loss of consciousness for longer than 30 minutes
• Presence of primary anxiety disorder, bipolar I or II disorder, or psychotic disorders
• Presence of anorexia nervosa or bulimia nervosa
• Presence or history of epilepsy or other seizure disorders
• Presence of significant Axis II disorder based on investigator judgment
• Presence of significant unstable medical condition
• Presence or past history of ADHD or significant learning disability
• ECTs (unilateral) within the past 12 months or bilateral ECT (ever)
• More than 2 failed adequate antidepressant treatments in the current episode
• Pregnant or breast-feeding females
• Have received treatment within the last 30 days with an investigational drug
• Prior non-response to either bupropion-XL or escitalopram
• Current treatment with Zyban (bupropion hydrochloride)
• Antidepressant treatment within the last week (within the last 3 weeks fluoxetine)