Clinical evaluation of bupropion combined with sertraline in the treatment of female patients with first-episode depression

Chen Zixin; Deng Xiangying; Huang Cheng

doi:10.3969/j.issn.1672-8157.2025.06.012

Abstract：Objective To explore the efficacy of bupropion combined with sertraline in female patients with first-episode de-pression and its influence on the levels of neural factors and sex hormones,so as to provide evidence for more effective therapeutic strategies.Methods A retrospective study were conducted.A total of 128 female patients with first-episode depression admitted to Hangzhou Linping District Hospital of Integrated Traditional Chinese and Western Medicine between January 2022 and December 2024 were enrolled and divided into the sertraline group(n=64)and the combination group(n=64).The sertraline group received sertraline monotherapy,whereas the combination group received bupropion in addition to the treatment regimen of the sertraline group,and both groups were treated for 8 weeks.The clinical efficacy after 8 weeks of treatment,the levels of neurotrophic fac-tors and sex hormones,quality of life before and after 8 weeks of treatment,and the incidence of adverse reactions were compared between the two groups.Results The total effective rate in the combination group and the sertraline group was 90.63%(58/64)and 76.56%(49/64),and the difference was statistically significant(χ2=4.614,P<0.05).After 8 weeks of treatment,the levels of serum norepinephrine,brain-derived neurotrophic factor,and neuropeptide Y increased in both groups,with higher levels observed in the combination group((11.31±1.79)μg·L-1,(42.35±4.61)μg·L-1,and(141.87±15.62)pg·mL-1,respectively)compared with the sertraline group((8.73±1.88)μg·L-1,(35.02±3.56)μg·L-1,and(124.29±16.57)pg·mL-1,respectively),with statistically significant differences(t=7.951,10.068,6.176,all P<0.05).After 8 weeks of treatment,serum estradiol and progesterone levels were elevated in both groups,and the combination group showed higher values((41.56±8.11)pmol·L-1 and(1.85±0.30)nmol·L-1,respectively)than the sertraline group((32.66±7.15)pmol·L-1 and(1.43±0.31)nmol·L-1,respectively),with statistically significant differences(t=6.585,7.789,both P<0.05).After 8 weeks of treatment,the scores of physiology,psychology,independence,environmental,social relationship,and spiritual support in both groups all increased.The combination group achieved significantly higher scores((70.35±6.19)points,(84.29±3.18)points,(79.01±6.78)points,(75.64±0.72)points,(72.08±8.95)points,and(75.20±4.24)points,respective-ly)than those in the sertraline group((62.77±6.38)points,(76.32±3.29)points,(68.28±6.81)points,(65.85±6.15)points,(66.08±8.25)points,and(66.60±4.45)points,respectively),with statistically significant differences(t=6.822,13.935,8.933,12.649,3.943,11.193,all P<0.05).The incidence of adverse reactions was 20.31%(13/64)in the combination group and 14.06%(9/64)in the ser-traline group,and the difference was not statistically significant(χ²=0.878,P>0.05).Conclusion Bupropion combined with ser-traline demonstrates a good effect on the treatment of female patients with first-episode depression,which can regulate the levels of neurotrophic factors and sex hormones,improve the quality of life of patients,and have good safety.