Bupropion

We did a systematic review and network meta-analysis. We searched the Cochrane Central Register of Controlled Trials, CINAHL, Embase, LILACS database, MEDLINE, MEDLINE In-Process, PsycINFO, AMED, the UK National Research Register, and PSYNDEX from the date of their inception to Jan 8, 2016, with no language restrictions. We used the search terms “depress*” OR “dysthymi*” OR “adjustment disorder*” OR “mood disorder*” OR “affective disorder” OR “affective symptoms” combined with a list of all included antidepressants.
We included double-blind, randomised controlled trials (RCTs) comparing antidepressants with placebo or another active antidepressant as oral monotherapy for the acute treatment of adults (≥18 years old and of both sexes) with a primary diagnosis of major depressive disorder according to standard operationalised diagnostic criteria (Feighner criteria, Research Diagnostic Criteria, DSM-III, DSM-III-R, DSM-IV, DSM-5, and ICD-10). We considered only double-blind trials because we included placebo in the network meta-analysis, and because this study design increases methodological rigour by minimising performance and ascertainment biases.⁷ (link) Additionally, we included all second-generation antidepressants approved by the regulatory agencies in the USA, Europe, or Japan: agomelatine, bupropion, citalopram, desvenlafaxine, duloxetine, escitalopram, fluoxetine, fluvoxamine, levomilnacipran, milnacipran, mirtazapine, paroxetine, reboxetine, sertraline, venlafaxine, vilazodone, and vortioxetine. To inform clinical practice globally, we selected the two tricyclics (amitriptyline and clomipramine) included in the WHO Model List of Essential Medicines). We also included trazodone and nefazodone, because of their distinct effect and tolerability profiles. Additionally, we included trials that allowed rescue medications so long as they were equally provided among the randomised groups. We included data only for drugs within the therapeutic range (appendix pp 133, 134). Finally, we excluded quasi-randomised trials and trials that were incomplete or included 20% or more of participants with bipolar disorder, psychotic depression, or treatment-resistant depression; or patients with a serious concomitant medical illness.
The electronic database searches were supplemented with manual searches for published, unpublished, and ongoing RCTs in international trial registers, websites of drug approval agencies, and key scientific journals in the field.⁸ For example, we searched ClinicalTrials.gov using the search term “major depressive disorder” combined with a list of all included antidepressants. We contacted all the pharmaceutical companies marketing antidepressants and asked for supplemental unpublished information about both premarketing and post-marketing studies, with a specific focus on second-generation antidepressants. We also contacted study authors and drug manufacturers to supplement incomplete reports of the original papers or provide data for unpublished studies.
Six pairs of investigators (ACi, TAF, LZA, SL, HGR, YO, NT, YH, EHT, HI, KS, and AT) independently selected the studies, reviewed the main reports and supplementary materials, extracted the relevant information from the included trials, and assessed the risk of bias. Any discrepancies were resolved by consensus and arbitration by a panel of investigators within the review team (ACi, TAF, LZA, EHT, and JRG).
The full protocol of this network meta-analysis has been published.⁸

We examined potential correlates of being very interested in a quitline service, including psychosocial, tobacco-related, and demographic characteristics of participants.
Perceived stress was measured by using the Cohen 4-item Perceived Stress Scale (PSS-4), which measures how frequently life situations in the past month were perceived as stressful (14 (link)). We calculated summary scores ranging from 0 to 16, with higher scores indicating greater perceived stress (Cronbach α = .58).
Depressive symptoms were measured by using the 2-item Patient Health Questionnaire-2 (PHQ-2) depression screener, which measures the frequency of depressive mood and anhedonia over the past 2 weeks (15 (link)). We calculated summary scores ranging from 0 to 6, with higher scores indicating greater frequency of depressive symptoms and a score of 3 or higher indicating possible depression.
Social support was measured by using 4 items adapted from the Patient-Reported Outcomes Measurement Information System (PROMIS) emotional support measure (16 (link)). Participants rated how much they agree or disagree (strongly disagree/disagree/agree/strongly agree) that they 1) have someone who understands their problems, 2) have someone who will listen to them when they need to talk, 3) have someone to turn to for suggestions about how to deal with a problem, and 4) have someone who will help them if they decide to quit smoking. We calculated mean scores ranging from 1 to 4, with higher scores indicating greater social support (Cronbach α = .84).
Nicotine dependence was measured by using the 2-item Heaviness of Smoking Index (17 (link)), which assesses number of cigarettes smoked per day and time between waking up and smoking a first cigarette. Scores range from 0 to 6, with higher scores indicating greater nicotine dependence.
Ambivalence about smoking was measured by using 3 items adapted from an attitudinal ambivalence scale, which assesses conflicting thoughts and feelings about smoking (18 (link)). Participants rated how much they agreed or disagreed that they 1) sometimes think smoking is good, while at other times think smoking is bad, 2) feel torn between wanting to smoke and not wanting to smoke, and 3) have mixed feelings about smoking. The response options for these 3 items were strongly disagree (score of 1), disagree (score of 2), agree (score of 3), and strongly agree (score of 4). We calculated mean scores ranging from 1 to 4, with higher scores indicating greater ambivalence about smoking (Cronbach α = .58).
Stage of readiness to quit was assessed by asking whether participants 1) were seriously thinking about quitting smoking in the next 6 months, and if so whether they 2) had a specific plan to quit smoking in the next 30 days (19 (link)). Participants not thinking about quitting smoking in the next 6 months were classified as being in the precontemplation stage; participants thinking about quitting in the next 6 months, but without a specific plan, were classified as being in the contemplation stage; and participants thinking about quitting in the next 6 months and having a specific plan to quit in the next 30 days were classified as being in the preparation stage.
Other tobacco-related items assessed whether participants lived with other smokers (yes/no) and used any cessation aid such as nicotine replacement therapy (NRT), Chantix, or “Zyban, bupropion, or Wellbutrin” during past quit attempts (yes/no).
We assessed participants’ age, sex, race, ethnicity, annual pretax household income, highest level of education, whether they had children younger than 18 years living in the home, and whether they lived in a rural or nonrural area, as determined by zip code (20 ).

Families were recruited through internet and newspaper services, local clinics, and patient support groups in Montréal, Québec. Families were mostly of white, middle-class, intact, and French-Canadian. Inclusion criteria for all families consisted of having at least one child between the ages of 6 and 11 years, and fluency in either English or French. General demographic information presented by risk status can be found in Table 1. Control families were excluded if either parent presented with a current axis-I disorder or reported a history of affective disorders. Inclusion criteria for families having a parent with BD consisted of have one parent with a BD1 or BD2 diagnosis. Psychopathology in parents was assessed with the Structured Clinical Diagnostic Interview for DSM-IV-R (SCID-I; 24). The sample consisted of 25 families with a parent having BD (72% mothers) and 28 families with parents having no mental disorders (90% mothers).Table 1

Demographic characteristics presented by risk-status

Variable	OBD	Control Offspring
Offspring age at first timepoint	7.77 years (SD = 1.74)	8.67 years (SD = 1.68)
Offspring sex
Girls	17	18
Boys	17	14
Family ethnicity
Aboriginal (e.g., First Nations, Inuit, Metis, Native American, Native Australian)	1	0
Black (e.g., African–American, Nigerian, Haitian, Jamaican, Somali)	0	4
East Asian, South-East Asian, Pacific Islander (e.g., Chinese, Japanese, Korean, Vietnamese, Thai, Filipino, Indonesian)	1	2
Hispanic/Latino/Latin-American (e.g., Brazilian, Chilean, Mexican, Cuban)	1	3
Middle Eastern, North African, Central Asian (e.g., Jordanian, Saudi, Egyptian, Moroccan, Iranian, Afghan, Tajikistani)	2	3
White (Caucasian)	20	16
Parental marital status
Single	5	2
Married	18	18
Separated	2	5
Divorced	0	3
Parental educational attainment
Highschool Diploma	1	0
CÉGEP Diploma	4	4
Some university achievement	1	3
University Degree	19	21
Family annual income
Less than $25,000	4	4
$25,001 to $50,000	8	8
$50,001 to $75,00	5	5
$75,001 to $100,000	1	7
More than $100,000	7	3
Family SES compositea	9.44 (SD = 2.10)	9.48 (SD = 1.67)

^aSES Composite = socioeconomic composite score, which combines both parental educational attainment and family annual income

Within families having a parent with BD, most affected parents presented with BD-I (90%), and all reported a history of depression. At the start of the study, most parents with BD were asymptomatic, while two were in a current manic episode. While the latter two individuals were included in the study on the basis of their diagnosis, it was their partners who completed the RUSH program and all accompanying assessments. For the other 23 families, the affected parents attended the program and completed all assessments. All parents with BD were receiving pharmacological treatment at the time of the study, which included various combinations of antidepressant (bupropion, citalopram, escitalopram, sertraline, venlafaxine; n = 6), anticonvulsant (divalproex, lamotrigine, topiramate, valproate, n = 12), antipsychotic (chlorpromazine, lurasidone, olanzapine, quetiapine, ziprasidone; n = 12) and mood stabilizing medication (lithium; n = 9).
There were 66 children across the 53 families (34 OBD; 32 control; 48% female), aged between 6 and 11 years (M = 8.20 years, SD = 1.20 years). None of the control offspring met criteria for a psychological disorder, while ten OBD had a current diagnosis at T1, including an anxiety disorder (n = 1), enuresis (n = 2), oppositional defiant disorder (n = 1), and attention deficit/hyperactivity disorder (n = 6; all of whom were being treated with psychostimulants). None of the OBD were receiving any psychosocial treatments throughout the duration of the study. Psychopathology in offspring was assessed with the parent-version of the Kiddie-Schedule of Affective Disorders and Schizophrenia-Present and Lifetime Version [K-SADS-PL; (Kaufman and Schweder 2004 ). Children were excluded on the basis of presenting with pervasive developmental disorder, an intellectual or chronic physical disorder, or any history of an affective or psychotic disorder. Groups of children did not significantly differ on any key demographic variable (e.g., sex, ethnicity, or socioeconomic status) (all p > 0.05).
Of the initial 25 families having a parent with BD who underwent the T1 assessment, 20 completed the RUSH program. Of the 20 families who completed the RUSH program, all returned for T2 and T3 assessments, but only 17 families were retained at T4. Families most commonly reported a lack of time as the reason for dropping out at T4. No differences were observed between the original sample and those who dropped out prior to participating in the RUSH program or at T4 with regards to various demographic variables (offspring and parent sex and age, socioeconomic status), parental diagnosis (BD-I v. BD-II), offspring psychopathology at T1, as well as parents’ baseline scores across all four scores of parenting stress (all p > 0.05).