Absence of orthostatic hypotension in depressed patients treated with bupropion

• 1.

  1. Bupropion HCI (Wellbutrin^®), a new antidepressant, has been reported to have low cardiovascular toxicity as a result of its specific inhibiting effect on the re-uptake of dopamine.

• 2.

  2. In order to investigate its effect on the cardiovascular system we administered bupropion for two weeks to 5 depressed patients who manifested clinically significant orthostatic hypotension while being treated with tricyclic antidepressants. Treatment with bupropion was preceded by one week of placebo washout.

• 3.

  3. Curing bupropion treatment none of the patients manifested significant orthostatic hypotension: in the 4 patients who completed the study the mean difference between supine and standing systolic blood pressure after 14 days of bupropion treatment (8.3 ± 2.5 mm Hg) was the same as after 7 days of placebo treatment (8.3 ± 3.2 mm Hg) and significantly (p < .001) lower than during treatment with tricyclics (22.3 ± 1.4 mm Hg).

• 4.

  4. Thus, buproprion appears to have the advantage that it does not induce orthostatic hypotension, which is potentially important in the treatment of the elderly and those with cardiovascular disease.