The purpose of this study is to determine whether there are age-related differences in the body systems controlling sleep and stress hormone patterns. This study will also determine whether the observed differences in sleep and hormone patterns between depressed adolescents and adults are associated with differences in their responses to antidepressant treatment.

Study hypothesis: 1) Depressed adolescents will reach rapid eye movement (REM) sleep faster and have higher cortisol levels in response to a single dose of bupropion compared with depressed adults who have taken single-dose bupropion. 2) Participants who take longer to reach REM sleep in response to single-dose bupropion will have better clinical response when treated with the drug compared with those who reach REM sleep faster in response to single-dose bupropion.

Adolescent depression is a serious public health concern that may lead to functional disability and death. The problems associated with the condition may continue into adulthood; therefore, early identification and effective treatment of adolescent depression is critical. Studies indicate that depressed adolescents experience greater variations in sleep and hormone patterns than depressed adults. These variations may influence responses to antidepressant treatment. This study will examine the mechanisms underlying developmental differences in sleep and hormone patterns to develop a strategy for identifying adolescents and adults who could benefit from antidepressant treatment.

This study will last 8 weeks. At study start, participants will be admitted to the medical center for a 2-night stay. On Night 1, participants will adapt to their surroundings. On the morning of Day 2, participants will be randomly assigned to receive a single dose of either the antidepressant bupropion or placebo. On Night 2, participants will have a catheter inserted into their bladders for urine collection and a test for cortisol, a stress hormone. Electrodes will be placed on participants' heads and bodies to measure the onset of REM sleep. On Day 3, participants will be discharged from the medical center and will continue to take bupropion or placebo twice daily for 8 weeks. After 8 weeks, participants will discontinue their assigned treatment and return to the medical center for another 2-night stay; the procedures performed during this stay will be similar to those conducted in the first. Night 1 will be an adaptation night. On Day 2, participants who previously received a placebo will receive bupropion treatment; those who previously received bupropion will receive a placebo. On Night 2, another sleep study and urine collection will occur. On Day 3, participants will complete depression self-report scales.

Ages Eligible for Study:  12 Years   -   50 Years,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• Diagnosis of major depressive disorder

Exclusion Criteria:

• Current treatment with antidepressant drugs
• Major medical illness
• Diagnosis of anorexia nervosa or manic-depressive illness
• Pregnancy