Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder…
Worth asking your prescriber whether adding bupropion to your current antidepressant, rather than switching outright, is an option if your current medication has not fully worked.
Well-supported by good-quality research. how we score evidence
Caveat on this rating: Government-funded (VA Cooperative Studies Program), but Bristol-Myers Squibb supplied the aripiprazole used in the comparison arm.
In 1,522 veterans whose depression had not responded to an antidepressant, switching to bupropion led to remission in 22.3% versus 26.9% for adding bupropion and 28.9% for adding aripiprazole; only aripiprazole augmentation significantly beat the bupropion switch (RR 1.30, 95% CI 1.05 to 1.60).
Worth asking
Worth asking your prescriber whether adding bupropion to your current antidepressant, rather than switching outright, is an option if your current medication has not fully worked.
What it is FDA approved for
Read off the label. Trial duration and approval year are shown only where they were recorded — never inferred.
- Major depressive disorder
- Prevention of seasonal major depressive episodes (seasonal affective disorder)
- Aid to smoking cessation
Source
Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial — Mohamed S, et al. (2017)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1001/jama.2017.8036
DOI: 10.1001/jama.2017.8036
How this was scored
- Study design
- Randomised controlled trial
- Funding
- Mixed public and industry funding
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 1,522
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Questions
How strong is the evidence behind this?
Resolv rates this source "strong evidence". Well-supported by good-quality research. It scores 83 out of 100 on our published rubric. One caveat travels with that badge: Government-funded (VA Cooperative Studies Program), but Bristol-Myers Squibb supplied the aripiprazole used in the comparison arm. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Effect of Antidepressant Switching vs Augmentation on Remission Among Patients With Major Depressive Disorder Unresponsive to Antidepressant Treatment: The VAST-D Randomized Clinical Trial — Mohamed S, et al. (2017). Published in: Top-tier peer-reviewed journal. DOI: 10.1001/jama.2017.8036. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Randomised controlled trial. Funding: Mixed public and industry funding. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is bupropion (Wellbutrin, Zyban, Aplenzin, Forfivo), wellbutrin, zyban, aplenzin, forfivo FDA approved?
Yes — FDA approved for Major depressive disorder, Prevention of seasonal major depressive episodes (seasonal affective disorder), Aid to smoking cessation. Approval is for a specific indication, not for everything the drug is prescribed for.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.