The role of dopaminergic agents in improving quality of life in major depressive disorder.

Quality of life (QOL) is greatly diminished in patients with major depressive disorder (MDD) before treatment. This deficit persists even when patients are in remission; thus, interventions are needed to improve QOL. This article reviews QOL impairment in MDD and the cost of impairment, then summarizes the empiric literature on the effects of dopaminergic agents on QOL in patients with MDD. Studies were identified through a MEDLINE search from the past 35 years (1974-2009) using key terms "quality of life," "major depression," and "major depressive disorder," and "dopaminergic," "bupropion," or "modafinil." A total of 47 studies were included in this review. A brief overview of the relationship between QOL and MDD is presented, followed by a review of dopaminergic agent chemistry, mechanism of action, use, and trials conducted to investigate agents' effects on QOL. Preliminary evidence suggests dopaminergic agents may have a positive effect on QOL for patients with MDD. Prospective, randomized, double-blind, placebo-controlled studies are needed to extend these findings.