Bupropion monotherapy alters neurotrophic and inflammatory markers in patients of major depressive disorder

Background: Emerging hypotheses in the pathophysiology of major depressive disorder (MDD) indicate the role of neurotrophic factors and inflammation. This study assessed the association between therapeutic response of bupropion and serum brain-derived neurotrophic factor (BDNF) and tumour necrosis factor-alpha (TNF-alpha) levels in patients with MDD. Methods: Thirty patients (aged 18 to 60 years) with MDD diagnosed by DSM-5 criteria, with Hamilton Depression Rating scale (HAM-D) score >= 20 were included in the study. Patients were given bupropion sustained release (SR) in the doses of 150 mg once daily. All patients were followed up for 12 weeks. Results: HAM-D score at the start of the treatment was 25.57 1.85 which significantly reduced to 10.8 +/- 4.24 at 12 weeks of treatment. The serum BDNF level increased significantly (p < 0.05) from 2.42 +/- 0.19 ng/ml to 2.97 +/- 0.10 ng/ml and the levels of serum TNF-alpha reduced significantly (p < 0.05) from 4.45 +/- 0.95 pg/ml to 2.11 +/- 0.84 pg/ml at 12 weeks of treatment, in responders to treatment. Conclusion: The results of our study suggest that bupropion SR monotherapy is effective and well tolerated in MDD patients with moderate to severe depression, and its therapeutic efficacy is accompanied by an increase in serum BDNF levels and a decrease in serum TNF-alpha levels.