Bupropion and venlafaxine responders differ in pretreatment regional cerebral metabolism in unipolar depression

John T. Little, Terence A. Ketter, Tim A. Kimbrell, Robert T. Dunn, Brenda E. Benson, Mark W. Willis, David A. Luckenbaugh, Robert M. Post

Research output: Contribution to journalArticlepeer-review

79 Scopus citations


Pretreatment functional brain imaging was examined for never-hospitalized outpatients with unipolar depression compared with control subjects in a crossover treatment trial involving bupropion or venlafaxine monotherapy. Patients (n = 20) with unipolar depression received baseline (medication-free) fluorine-18 deoxyglucose (FDG) positron emission tomography (PET) scan and then at least 6 weeks of bupropion or venlafaxine monotherapy in a single-blind crossover trial. Age-matched healthy control subjects (n = 20) also received baseline FDG PET scans. For each medication PET data from patients compared with control subjects was analyzed as a function of treatment response (defined as moderate to marked improvement on the Clinical Global Impression Scale). Treatment response rates were similar for buproprion (32%) and venlafaxine (33%). Compared with control subjects, responders but not nonresponders, to both drugs demonstrated frontal and left temporal hypometabolism. Selectively, compared with control subjects bupropion responders (n = 6) also had cerebellar hypermetabolism, whereas venlafaxine responders (n = 7) showed bilateral temporal and basal ganglia hypometabolism. These data suggest that pretreatment frontal and left temporal hypometabolism in never-hospitalized depressed outpatients compared with control subjects is linked to positive antidepressant response and that additional alterations in regional metabolism may be linked to differential responsivity to bupropion and venlafaxine monotherapy.

Original languageEnglish (US)
Pages (from-to)220-228
Number of pages9
JournalBiological psychiatry
Issue number3
StatePublished - Feb 1 2005


  • Bupropion
  • depression
  • positron emission tomography
  • treatment response
  • unipolar
  • venlafaxine

ASJC Scopus subject areas

  • Biological Psychiatry


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