Abstract / Summary
Background and objectives Type 2 diabetes mellitus (T2DM) and depression needs to be treated as an interconnected condition. Considering T2DM-related concerns amongst antidepressants, bupropion has a favourable metabolic profile including weight control, apart from a lower risk of sexual dysfunction. We studied the role of bupropion in patients with T2DM for ≥5 y and mild depression to assess effect on metabolic, self-care, and related parameters. Methods This crossover RCT randomly assigned (1:1) participants with T2DM and antidepressant-naive mild depression to receive bupropion 150-mg once daily or standard care alone for three months, followed by a one-month washout period, the interventions were swapped for another three months. The co-primary endpoints were changes in HbA1c and self-care adherence, both of which had to be significant to claim benefit. Results 54 male patients with a mean±SD age of 50.9±7.7 y and HbA1c of 9.05±0.97% were recruited, with 27 each randomised to receive bupropion or standard care, each. Of these, 46 crossed over and 38 completed the study. HbA1c improved with both bupropion (-0.74%; 95% CI, -0.89 to 0.59) and standard care alone (-0.56%; -0.66 to -0.46), with an estimated treatment difference at endpoint of -0.06% (-0.34 to 0.22, P =0.69). Self-care adherence also improved with both bupropion (2.40 points; 1.87 to 2.93) and standard care alone (2.40 points; 1.93 to 2.86) with an estimated treatment difference at endpoint of -0.04 points (-0.93 to 0.85, P =0.93). There were no serious adverse events. Interpretation and conclusions Adding Bupropion to standard therapy for treatment of T2DM with mild depression, does not offer any benefit in terms of glycaemic control and self-care adherence.