Neuroimaging Study of Bupropion Treatment in Patients With Major Depressive Disorder

• Change from Baseline in Depressive Symptom Scores at 8 Weeks [ Time Frame: Baseline and at 8 Weeks ] [ Designated as safety issue: No ]
• Change from Baseline in Depressive Symptom Scores at 4 Weeks [ Time Frame: Baseline and at 4 Weeks ] [ Designated as safety issue: No ]
• Change from Baseline in Depressive Symptom Scores at 1 Week [ Time Frame: Baseline and at 1 Week ] [ Designated as safety issue: No ]

• Number of Participants with Adverse Events [ Time Frame: 1 Week ] [ Designated as safety issue: Yes ]
• Change from Baseline in Neurocognitive Function as Expressed as Z Scores Transformed Using the Control Group Mean and Distribution Values at 8 Weeks [ Time Frame: Baseline and 8 Weeks ] [ Designated as safety issue: No ]
• Changes from Baseline in Brain Structure and Function, Analyzed Using the Computational Approach [ Time Frame: Baseline and 8 Weeks ] [ Designated as safety issue: No ]
• Number of Participants with Adverse Events [ Time Frame: 4 Weeks ] [ Designated as safety issue: Yes ]
• Number of Participants with Adverse Events [ Time Frame: 8 Weeks ] [ Designated as safety issue: Yes ]

The current study is being conducted in patients with major depression. The study aims to 1) investigate the combined effects of selective serotonin reuptake inhibitor (SSRI) and bupropion compared to SSRI alone on the improvements of depressive symptoms, fatigue, hypersomnia, and neurocognitive functions, 2) observe structural/functional/chemical changes using magnetic resonance imaging (MRI), 3) and examine a relationship between the improvements of depressive symptoms, fatigue, and hypersomnia and the neural changes.

• Drug: Bupropion, Escitalopram
  Week 0-1: Escitalopram 10mg, Bupropion 150mg Week 2-3: Escitalopram 10mg, Bupropion 300mg Week 4-8: Escitalopram 20mg, Bupropion 300mg
• Drug: Escitalopram
  Week 0-3: Escitalopram 10mg Week 4-8: Escitalopram 20mg

• Experimental: Escitalopram + Bupropion
  Intervention: Drug: Bupropion, Escitalopram
• Active Comparator: Escitalopram
  Intervention: Drug: Escitalopram

Inclusion Criteria:

• Men and women aged between 20 and 65
• Diagnosis of major depressive disorder (MDD) as assessed by the Structured Clinical Interview for DSM-IV (SCID-IV)
• Individuals who provided written consent for participation.

Exclusion Criteria:

• Presence of any major physical or neurological illness (e.g., head trauma, epilepsy, seizure, stroke, cerebral tumor, multiple sclerosis, cerebrovascular disease, narrow-angle glaucoma, drug hypersensitivity, etc.)
• Diagnosis of any Axis I disorder other than MDD or presence of symptoms requiring hospitalization
• Intelligence quotient (IQ) below 80
• Contraindications to magnetic resonance imaging (e.g., pacemaker implantation, claustrophobia, etc.)
• Unstable medical illness or other abnormalities observed at the screening or laboratory tests
• Women who are pregnant, breastfeeding, or planning pregnancy
• Allergy or tolerance to the clinical trial medication
• Presence of any physical illness that contraindicates the clinical trial medication (e.g., epilepsy, history of uncontrollable narrow-angle glaucoma)
• Use of psychoactive medications that may affect brain imaging findings